目的：通过对郑州地区献血者进行酶免筛查后再实施核酸检测（NAT），探讨增加NAT在临床输血中的必要性及可行性。方法采用罗氏全自动核酸筛查系统和上海科华全自动核酸筛查系统检测 HBV DNA、HCV RNA、HIV RNA，样本混合分别采用6人份×166．7μL 及8人份×180μL 汇集（称为1个 pool），如果混检阴性，则直接出具结果；如混检阳性，再进行二次拆分检测，以拆分结果报告最终结果。结果罗氏系统共检测 ELISA 阴性标本115227份，其中混检阳性 pool 130个，经拆分80个 pool 为反应性，反应性标本86例，拆分率为61．5％，标本阳性率0．75‰；科华系统共检90359份 ELISA 阴性标本，混检阳性pool 93个，经拆分31个 pool 为反应性，反应性标本31例，pool 拆分率33．3％，标本阳性率为0．34‰。二者总计共检标本205586份，反应性标本117例，标本阳性率0．57‰，其中 1例为 HIV“窗口期”感染。结论核酸检测可以有效降低酶免漏检造成的输血风险，进一步保障输血安全。%Objective To discuss the necessity and feasibility of nucleic acid test(NAT)in clinical blood transfusion by the im-plementation of the nucleic acid testing after the ELISA screening of Zhengzhou blood donors.Methods HBV DNA,HCV RNA, HIV RNA were detected by Roche Cobas S201 system and Shanghai kehua screening system,the samples were mixed by 6×166.7μL and 8×180 μL(as one pool)separately.If the mix pool was negative,the result can be issued directly;if the pool was positive, than secondary single sample dectection must be taken and the secondary report was the final result.Results A total of 115 227 blood samples were screened by Roche Cobas S201 system and 130 mix pools were positive,among which 80 pools were reactive by secondary split testing,and the reactive samples were 86,the split ratio was 61.5%,The positive ratio of specimens was 0.75‰.90 359 samples were screened by kehua system,and the mixed pools were 93,among which 31 pools were reactive by secondary split testing,and the reactive samples were 31,the split ratio was 33.4%,The positive ratio of specimens was 0.34‰.So the total num-ber screened by the two systems was 205 586,among which 117 cases were reactive,the total positive ratio of specimens was 0.57‰.And one case was HIV window phase infection.Conclusion NAT could effectively decrease the risk of blood transfusion caused by omission of ELISA and ensure the safety of blood transfusion.
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