2015—2019年云南省艾滋病确证实验室血清学检测能力验证结果分析

目的 分析查找云南省艾滋病确证实验室血清学检测存在的问题，及时改进，提高检测能力和水平。方法 对人类免疫缺陷病毒抗体快速试验、筛查确证和条带判读的平均分和满分实验室比例进行分析。结果 2015—2019年，云南省分别有36、58、73、86和115家艾滋病确证实验室参加全国血清学检测能力验证。快速试验平均分98.95～100分，满分实验室比例98.18%～100%。筛查确证平均分97.71～99.70分，满分实验室比例86.11%～96.55%，有上升趋势（χ2 = 15.21, P＜0.05）。县级实验室提升明显（χ2 = 56.73, P＜0.05）。条带判读平均分91.14～97.38分，满分实验室比例54.39%～91.67%。2019年能力验证中，首次参加的实验室条带判读满分比例明显低于已参加过的实验室（χ2 = 8.32, P＜0.05）。25家实验室被扣分，80%（20/25）为县级实验室。33.33%（6/18）的非疾控系统实验室未得满分。结论 云南省艾滋病确证实验室不断向县级疾控中心和艾滋病抗病毒治疗定点机构推进。HIV抗体检测水平整体较高。通过开展能力验证，实验室检测水平得到提升。条带判读是薄弱环节，需持续开展强化培训，尤其是针对新开展工作的实验室。省级和州级中心实验室应加强县级实验室和非疾控系统实验室的质量管理，进行现场指导和技术支持。

Proficiency testing results of serological test in AIDS confirmation laboratories in Yunnan Province from 2015 to 2019

Objective To analyze and find the problems of serological testing in AIDS confirmation laboratories in Yunnan Province, so as to improve timely and enhance the testing ability and level. Methods The average scores and percentage of full-scoring laboratories for rapid HIV antibody tests, screening confirmatory and band interpretation were analyzed. Results From 2015 to 2019, 36, 58, 73, 86 and 115 AIDS confirmation laboratories of Yunnan Province participated in the national proficiency testing. The average score of rapid test was 98.95-100 points, and the proportion with full score was 98.18-100%. The average score of screening and confirmation test was 97.71-99.70 points, and the proportion of full-scoring laboratories was 86.11-96.55%, with an upward trend(χ2=15.21, P<0.05). The county laboratories had obvious improvement(χ2=56.73, P<0.05). For the band interpretation assessment, the average score was 91.14-97.38 points, and the proportion of full-scoring laboratories was 54.39-91.67%. In the proficiency testing in 2019, the proportion of full scores for strip interpretation of laboratories participating for the first time was significantly lower than that of laboratories that had already participated(χ2=8.32, P<0.05). In total 25 laboratories were penalized, 80%(20/25) of which were county laboratories. A total of 33.33%(6/18) of non-CDC laboratories did not score a full mark. Conclusion The network of AIDS confirm laboratories in Yunnan province has been continuously promoted to county-level CDCs and designated institutions for AIDS antiviral treatment. The detection level of HIV antibody is high overall. Through carrying out proficiency testing, the ability of detecting HIV antibody has been improved. The band interpretation assessment is a weak link and requires continuous and intensive training, especially for new laboratories. Provincial and state central laboratories should strengthen the quality management of county laboratories and non-CDC laboratories and provide on-site guidance and technical support.