金免疫层析试验用于受血者输血前HBsAg等项目检测结果分析.DOCVIP

临床医学论文-金免疫层析试验用于受血者输血前HBsAg等项目检测结果分析 ????????????????????? 作者：李宏杰，方磊，程家坤，黄元丽 【关键词】? 乙型肝炎表面抗原；金免疫层析试验；特异性与敏感性；受血者；输血；医疗纠纷 　［摘要］? 目的? 比较金免疫层析试验(GICA)与ELISA检测HBsAg的结果符合率，了解GICA的特异性与敏感度。方法? 用GICA和ELISA平行检测受检者血清标本HBsAg。结果? GICA和ELISA检测HBsAg的结果符合率为99.09%，GICA测HBsAg存在漏检（即假阴性）。结论? GICA较ELISA敏感度低，用GICA检测HBsAg等项目存在一定程度的漏检率；GICA快速诊断法不宜用于受血者输血前HBsAg等项目的检测，为有效避免或减少因输血而引起的医疗纠纷的发生，输血前对受血者应用ELISA进行血液传播性疾病的检测（或初筛）十分必要。 　　［关键词］? 乙型肝炎表面抗原；金免疫层析试验；特异性与敏感性；受血者；输血；医疗纠纷 　　Analysis on the detection of sample HBsAg and other immune items by GICA in recipients of blood before blood transfusion 　　［Abstract］? Objective? To compare the variation rate between GICA and ELISA for detecting serum HBsAg，thus to determine specificity and sensitivity of GICA.Methods? Serum HBsAg in patients and volunteers was detected by GICA and the results were also detected by ELISA as a control.Results? The HBsAg accord rate between GICA and ELISA is 99.09%，GICA exists false-negative of HBsAg.Conclusion? GICA is of a little lower sensitivity than ELISA is　and exists false-negative of HBsAg and other immune items to a greater or lesser extent；GICA should not be used to detect HBsAg and other immune items in recipients of blood before blood transfusion，to avoid dispute of medicine or decrease the rate of dispute of medicine efficiently，it is suggested that blood transmissible diseases should be detected (or sift-detected) by ELISA in recipients of blood before blood transfusion. 　　［Key words］? HBsAg；GICA；specificity and sensitivity；recipients of blood；blood transfusion；dispute of medicine 　　乙肝、丙肝、梅毒、艾滋病等均为输血相关传染病，可通过血液传播［1］。输血是临床治疗疾病的重要手段之一，为保证输血安全，我国规定献血者在献血前必须经过血型、HBsAg、抗-HCV、抗-HIV1/2、ALT、梅毒螺旋体抗体和血红蛋白等7个项目的检测［1］。HBsAg、抗-HCV、抗-HIV1/2（初筛）、梅毒螺旋体抗体（初筛）检测均须采用ELISA法［1～3］。尽管如此，因输血引起的医疗纠纷仍时有发生［1，3］。鉴于人群中的HBV、HCV和梅毒螺旋体等感染普遍存在，受血者HBV、HCV和梅毒螺旋体等感染也均有存在（我地区HBsAg阳性率为15.30%［3］，高于全国平均水平10.09%［4］），所以对受血者进行输血前HBsAg、抗-HCV、抗-HIV1/2、ALT、梅毒螺旋体抗体的检测也同样非常重要，这样可以有效地避免或减少因输血引起的医疗纠纷的发生［3］。而使用金免疫层析试验（GICA）检测HBsAg等项目能否代替ELISA，成为检验医学十分关注的一个问题