摘要
分析无偿献血者中HIV抗体初筛阳性与蛋白印迹试验（WB）确认结果的关系，评估WB确认方法在HIV抗体检测过程中的必要性和可行性，以及实验中存在的一些问题。对326568份无偿献血者标本进行HIV抗体初、复检，初筛阳性的标本为全部样本，再用现在市场上较认可的ELISA试剂和WB试验同时进行检测，比较两种方法检测结果之间的关系。ELISA与WB结果一致性71．17％，阳性符合率为48．78％，阴性符合率为83．13％；以确认结果为金标准，得出ELISA检测HIV抗体试剂的敏感性为100％，特异性为84．15％。WB阳性组与阴性组比较，t=15．21，P〈0．001，显示阳性和阴性组间S／CO值存在显著差异；WB阳性组与不确定组比较，t=13．07，P〈0．001，显示阳性和不确定组间S／CO值存在显著差异；不确定组与ELISA假阳性（WB确认阴性而ELISA阳性）比较，t=2．13，P〉0．05，无统计学差异，提示WB不确定结果可能是假阳性；20份确认阳性的标本的S／CO值全部大于5，确认阴性与不确定的91份标本中，S／CO低于1的占71份，在1～2．999之间19份；6个月后随访WB不确定的供血者，带型无变化，全部被诊断为阴性。较高的S／CO值（〉5）预示HIV抗体阳性的可能性大；而低于2．999时，预示阳性可能性小；WB方法确认HIV抗体阳性和阴性准确，不足之处为存在不确定结果，给工作带来许多不便。
To analyze the relation between the results of ELISA and WB to test positive HIV antibody of screening test in blood donors, evaluate the need for and feasibility of WB in identifying HIV antibody, and find some existing problems. HIV antibody of 326568 blood donors was tested twice, during which all positive samples were subjects of this experiment. These samples were simultaneously tested, by comparatively accepted ELISA reagent and WB, and the relation between testing results of the two methods was compared. Samples of the same testing result account for 71.7% ; the rate of positive accordance was 48.78% and the rate of negative accordance was 83.13% ; With WB as a true criteria, the sensitivity of ELISA reagent of HIV antibody was 100% and specificity was 84.15%. When the positive group was compared with negative one, t = 15.21 ,P 〈0. 001, which indicates remarkable statistical difference in S/CO between positive group and negative one. Comparing positive group with unidentified that, t = 13.07 ,P 〈 0.001, which indicates remarkable statistical difference in S/CO between positive group and unidentified one. Comparing unidentified group with false-positive group that is negative by WB but positive by ELISA, t =2. 13, P 〉0.05, which indicates no statistical difference in S/CO between two groups and unidentified result possible is false-positive. All value of S/CO in 20 identified positive samples were greater than 5 ; samples whose value of S/CO were below less 1 were 71, and those between 1 and 2. 999 were 19. Blood donors of unidentified HIV antibody were revisited after 6 months, whose testing results remain invariable, so they were diagnosed as negativity. The high value of S/CO（〉5） indicates more possibility of positive HIV antibody, but when the value is less 2. 999, the possibility of positive HIV antibody is small. It is comparatively accurate for WB to identify positive and negative samples. The flaw of WB consists in unidentified results, which bring about many troubles at work.
出处
《科学技术与工程》
2008年第6期1419-1423,共5页
Science Technology and Engineering
基金
卫生部艾滋病防治应用性研究项目(2006第34号)资助
