无偿献血者传染性标志物合并阳性感染情况分析

摘要

目的：探讨无偿献血人群丙氨酸氨基转移酶（ALT）、乙型肝炎表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）与梅毒螺旋体抗体（抗-TP）等指标合并阳性感染情况及人群分布特点，为制订血液筛查标准提供依据。方法对2010~2014年安阳市无偿献血者293310例血液标本中，127例合并阳性感染2项及以上传染性标志物的血液标本进行统计分析。结果 ALT+HBsAg阳性标本51例，ALT+抗-HCV阳性标本37例，ALT+抗-TP阳性标本14例，HBsAg+抗-HCV阳性标本3例，HBsAg+抗-TP阳性标本5例，抗-HCV+抗-TP阳性标本6例，抗-HCV+抗-HIV阳性标本3例，抗-TP+抗-HIV阳性标本6例，ALT+HBsAg+抗-HCV阳性标本1例，ALT+抗-HCV+抗-HIV阳性标本1例。传染性标志物合并阳性感染人群分布特征：不同性别、不同年龄组及不同居住地传染性标志物合并阳性发生率比较，差异均有统计学意义（χ2=10.80、12.18、8.43，P＜0.05）。ALT不合格率与HBsAg、抗-HCV导致的ALT不合格率比较，差异均无统计学意义（P＞0.05）。结论 ALT检测不能作为是否感染乙型肝炎病毒或HCV的特异性检测指标。TP合并其他感染较多，应加强献血人群梅毒筛查和预防的宣传教育工作，更有利于输血安全。%Objective To explore the merged positive infection situation of ALT,HBsAg,anti-HCV antibody,anti-HIV antibody and anti-TP antibody in voluntary blood donors and their population distribution characteristics so as to provide a basis for formulating the blood screening standard. Methods Among 293 310 blood specimens in voluntary blood donors during 2010-2014,127 cases of merged positive infection of 2 contagious serum markers or more were statistically analyzed. Results Fifty-one specimens were ALT+HBsAg positive,37 specimens were ALT+anti-HCV positive,14 specimen were ALT+anti-TP positive,3 specimens were HBsAg+anti-HCV positive,5 specimen were HBsAg+anti-TP positive,6 specimen were anti-HCV+an ti-TP positive,3 specimen were anti-HCV+anti-HIV positive,6 specimens were anti-TP+anti-HIV positive,1 specimen was ALT+HBsAg+anti-HCV positive and 1 specimen was ALT+anti-HCV+anti-HIV positive. The distribution characteristics of the population with contagious serum markers merged positive infection were as follows:the merged positive occurrence rates of con-tagious serum markers had statistical differences between genders and among different age groups and different residence places (χ2=10.80,12.18,8.43,P<0.05). Comparing the ALT disqualification rate with the ALT disqualification rate of HBsAg and anti-HCV, the difference was not statistically significant(P>0.05). Conclusion The ALT detection can not serve as a specific detec-tion index of HBV or HCV infection. TP merged other infections are common. The prevention and propaganda education work of syphilis screening should be strengthened , which is more conducive to blood transfusion safety.