本文選題：獻(xiàn)血人群　切入點(diǎn)：流行病學(xué)　出處：《青島大學(xué)》2017年碩士論文

【摘要】：目的了解濰坊地區(qū)無(wú)償獻(xiàn)血人群經(jīng)血傳播疾病(乙型病毒性肝炎、丙型病毒性肝炎、艾滋病、梅毒)的感染及合并感染情況,為獻(xiàn)血人群的選擇和招募安全血源的策略提供理論依據(jù);并對(duì)兩套檢驗(yàn)體系(ELISA(酶聯(lián)免疫吸附測(cè)定,Enzyme Linked Immunosorbent Assay)、NAT(核酸檢測(cè),Nucleic Acid Test))的結(jié)果差別進(jìn)行統(tǒng)計(jì)分析,探討現(xiàn)行實(shí)驗(yàn)條件下獻(xiàn)血者標(biāo)本的實(shí)驗(yàn)室檢測(cè)方案。方法對(duì)濰坊市2011年1月-2015年12月共423412位志愿獻(xiàn)血者(18~55周歲)進(jìn)行HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)、抗-TP等感染標(biāo)志物的檢驗(yàn)(每個(gè)項(xiàng)目?jī)煞N酶免試劑同步檢測(cè)),結(jié)合無(wú)償獻(xiàn)血者的個(gè)人資料,對(duì)無(wú)償獻(xiàn)血者按不同獻(xiàn)血年份、性別、年齡區(qū)間、職業(yè)、學(xué)歷等組別進(jìn)行劃分,得出幾種經(jīng)血傳播疾病檢測(cè)指標(biāo)的感染和合并感染情況,分析其流行病學(xué)特征。同時(shí)對(duì)2015年3月-9月間(2015年起ELISA檢測(cè)不合格樣本進(jìn)行HBV DNA、HCV RNA、HIV RNA混樣模式檢測(cè))獻(xiàn)血者HBs Ag、抗-HCV、HIV Ag/Ab實(shí)驗(yàn)不合格樣本(80例、110例、90例)分別進(jìn)行HBV DNA、HCV RNA、HIV RNA單人份重復(fù)測(cè)試,并分析兩種檢測(cè)方法的相關(guān)性,探討實(shí)驗(yàn)室血液檢測(cè)策略。結(jié)果(1)濰坊市2011—2015年無(wú)償獻(xiàn)血者HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)、抗-TP檢測(cè)不合格率分別為0.36%、0.31%、0.19%、0.55%。(2)不同年份組間、不同年齡區(qū)間組間、不同職業(yè)組間、不同學(xué)歷組間HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)、抗-TP檢驗(yàn)結(jié)果不合格率的差別均有統(tǒng)計(jì)學(xué)意義(P0.05);不同性別間HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)檢測(cè)不合格率差異均有統(tǒng)計(jì)學(xué)意義(P0.05),而抗-TP不合格率無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(3)合并感染中,HBV+HCV、HBV+HIV、HBV+TP、HCV+HIV、HCV+TP、HIV+TP合并陽(yáng)性分別為19例、11例、21例、5例、16例、37例,HBV+HIV+TP合并陽(yáng)性1例,以TP合并其他感染性指標(biāo)人數(shù)最多(75/110),又以TP與HIV合并感染最多(37/75);合并感染者的年齡區(qū)間、性別、學(xué)歷、職業(yè)組間差別均有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)84577份獻(xiàn)血者HBs Ag、抗-HCV、HIV Ag/Ab檢測(cè)陰性標(biāo)本中,檢出HBV DNA 16例,HCV RNA 0例、HIV RNA 3例;HBs Ag、抗-HCV、HIV Ag/Ab酶免檢測(cè)結(jié)果陽(yáng)性標(biāo)本中,HBV DNA、HCV RNA、HIV RNA單人份復(fù)測(cè)陽(yáng)性率分別為40%(32/80)、20.9%(23/110)、22.2%(20/90),且NAT不合格標(biāo)本以ELISA兩種試劑均陽(yáng)性為主(73/75)。結(jié)論(1)濰坊市無(wú)償獻(xiàn)血者感染性指標(biāo)中,HBV感染率近年呈下降趨勢(shì),HCV、HIV、TP感染率呈升高趨勢(shì),且不同性別、年齡區(qū)間、職業(yè)、學(xué)歷間感染率有差別。(2)獻(xiàn)血者有合并感染狀況,以TP合并HIV感染為主。(3)初篩可降低感染性指標(biāo)的不合格率,可增加梅毒快速初篩項(xiàng)目。(4)核酸檢測(cè)可縮短病毒感染檢測(cè)的“窗口期”,與ELISA檢測(cè)方法互為補(bǔ)充。(5)可考慮應(yīng)用一種酶免疫方法檢測(cè)加核酸混樣檢測(cè)模式。
[Abstract]:Objective to investigate the infection and co-infection of blood-borne diseases (viral hepatitis B, hepatitis C, AIDS, syphilis) among unpaid blood donors in Weifang area. To provide a theoretical basis for the selection of blood donors and the strategy of recruiting safe blood sources, and to analyze the difference between the results of two test systems, Enzyme Linked Immunosorbent Assayama (nucleic Acid Test). To probe into the laboratory detection scheme of blood donor specimen under the present experimental conditions. Methods 423412 volunteer blood donors from January 2011 to December 2015 in Weifang City were tested for HBs Ag(HBV DNA, anti-HCV Ag(HBV RNA, anti-HIV Ag/Ab(HIV RNA, anti-TP and other infection markers. (two enzyme immunoassay kits for each item, combined with the personal data of the unpaid blood donor, According to different blood donation years, sex, age range, occupation, educational background and other groups of unpaid blood donors, the infection and co-infection of several blood transmission diseases were obtained. At the same time, from March to September 2015, the blood donors of HBs Agin and the unqualified samples of anti-HCV Ag/Ab test were tested by HBs Agand 90 cases of anti-HCV Ag/Ab test, respectively, from March to September of 2015 (from 2015 to 2015 when the unqualified ELISA samples were tested for HBV DNA HCV RNA RNA-HIV RNA mixed sample model) and 80 unqualified samples for anti-HCV Ag/Ab test. HBV DNA-HCV RNA RNA HBV RNA single copy repeat test, The correlation between the two methods was analyzed and the laboratory blood test strategy was discussed. Results 1) in Weifang City from 2011 to 2015, the unqualified rates of HBs Ag(HBV DNA, anti-HCV Ag(HBV RNA and anti-HCV Ag/Ab(HIV were 0.360.31 0.19 0.55.2. among different age groups, the unqualified rates were 0.36%, 0.31% and 0.55%, respectively, among the groups of different ages, the unqualified rate of anti-HCV detection was 0.360.31 (0.19) 0.55.2in Weifang City, the unqualified rate of anti-HCV Ag(HBV was 0.360.31 0.190.55.2in different years, Between different occupational groups, There were significant differences in the unqualified rates of HBs Ag(HBV DNA, anti-HCV Ag(HBV and anti-HCV Ag/Ab(HIV RNAs and anti-TP among different education groups, and there were significant differences in the unqualified rates of HBs Ag(HBV DNA and anti-HCV HBs HBs Ag/Ab(HIV among different genders (P0.05and anti-TP). There was no significant difference in the rate of HIV TP co-infection. The positive rate of HIV TP was 19 cases (11 cases), 5 cases (16 cases) and 37 cases (37 cases) were positive for HBV HIV TP, respectively, in 19 cases (11 cases), 16 cases (16 cases) and 37 cases (1 case). TP combined with other infectious indexes had the highest number of people (75 / 110), and TP and HIV had the most co-infection (37 / 75). There were significant differences in the age range, sex, educational background, and occupational groups among the infected individuals. There were significant differences in the age range, sex, educational background, and occupational groups of 84577 blood donors with HBs Agand anti-HCV Ag/Ab negative samples. 16 cases of HBV DNA, 0 cases of RNA and 3 cases of HBs Ag.Among the positive specimens of anti-HCV DNA Ag/Ab Ag/Ab, the repeat positive rate of single HIV RNA was 4032 / 80% 20. 9% 20. 9% 20. 2% 20. 2% and NAT substandard samples were mainly positive for ELISA and 73% 75%. Conclusion: 1) in Weifang, the positive rate is 73.75%. The infection rate of hepatitis B virus (HBV) in blood donors was decreasing in recent years. The infection rate of HIV / TP was increasing. The infection rate of blood donors was different among sex, age range, occupation and educational background. The primary screening of TP combined with HIV infection could reduce the unqualified rate of infectious index. Nucleic acid detection can shorten the window period of virus infection detection. It is complementary to ELISA detection method. It can be considered to use an enzyme immunoassay plus nucleic acid mixed sample detection mode.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R181.3

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