无偿献血血液不同筛查模式应用效果研究

目的评价临床用血血样不同筛查模式的应用效果，以降低无偿献血血液报废率，提高临床输血安全性。方法对不同时期临床用血采用不同传染性救病筛查模式进行筛查，并考核其安全性。结果自1997年开始，按照国家规定，临床用血安全性筛查项目包括HbsA异、抗-HCV、ALT、梅毒和抗-HIV。1997年检测个体卖血血样3442份，报废血样3份，报废率为0．08％。无偿献血血样28650份，报废血样4077份，报废率为14．23％；1998～2002年检测无偿献血血样206948份，报废血样12479份，报废率下降到6．03％：2003年检测无偿献血血样44529份，报废血样1465份，报废率再次下降到3．29％；2004年起对16592例无偿献血HBsA异、抗-HCV、抗-HIV ELISA方法检测阴性的标本进行PCR法复检，重新发现HBsA异阳性标本8例，为0．048％。结论对无偿献血者采血前进行快速筛查，能有效降低无偿献血的报废率，提高临床用血安全性，减少临床用血安全事故发生。

Investigation into the results of various models in screening of voluntarily donated blood

Objective To explore different clinical blood screening models for reducing blood positive rate and blood condemnation rate, and enhancing the security of blood transfusion. Methods The condemnation rate of donated blood collected in 1997 for clinical use were screened with different models and compared with the results of from 1998 to 2003 by fast screening of HBsAg and ALT. Meanwhile the nucleic acid - based detection results were also analyzed. Results The positive condemnation rate of individ- ual donated blood in 1997 was 0.08%, while the positive condemnation rate of unpaid donated blood was 14.23% ; Through the fast screening of HBsAg, positive blood condemnation rate of unpaid donated was reduced to 6.03% ; 50% blood samples were screened for ALT and the results showed that the positive blood condemnation rate of unpaid donated in 2003 dropped to 3.29% . Then, 16, 592 blood samples from voluntary blood donors which were negative for HBsAg, anti - HCV, anti - HIV, as measured by the ELISA method, were subjected to the nucleic acid detection. 8 samples were positive for HBsAg , with a positive rate of 0.048% . Conclusion Through fast screening of voluntary blood donors before blood collection, blood condemnation rate in our center has reduced from 14.23% in 1997 to 3.29% in 2003. If this model could be generally popularized, the goal of reducing the positive rate of voluntary blood donors and blood condemnation rate would be achieved. In addition, the nucleic acid - based examination may effectively enhance positive pick - up rate of HBsAg and guarantee the quality of blood.