郑国琴 何静晓

【摘 要】目的：探讨化学发光技术在无偿献血人群中乙型肝炎病毒（简称乙肝）两对半检测中的应用效果。方法：收集2017年9月至2018年11月期间，经酶联免疫吸附试验检测呈反应性的120例无偿献血标本，用化学发光法进行乙肝五项定量检测。结果：120例献血者中，有34例为未感染人群;大三阳为4例，占4.65%，小三阳为59例，占68.60%;其他类型23例，占26.74%。五项两对半指标阳性率最高的为抗-HBc，为98.84%;其次为HBsAg，占79.07%;阳性率最低的为E抗原，仅为5.81%。结论：无偿献血人群中乙肝两对半多为“小三阳”组合，病毒复制停止，但是仍然存在输血传播风险。化学发光定量檢测，可以弥补酶联免疫法定性检测的不足，也能更客观的为乙肝反应性献血者提供解释。

【关键词】化学发光;乙肝病毒;两对半定量

Summary： Purposes： To assess the application values of chemiluminescence technology in detecting hepatitis B virus （abbreviated as HBV） using 5 immunological markers in volunteers of blood donors. Method： Samples were collected between September 2017 and November 2018. One hundred and twenty cases of reactive blood samples by enzyme-linked immunosorbent assay were analyzed by five quantitative tests for hepatitis B using chemiluminescence. Result： In the 120 blood donors， 34 of which were uninfected; 4 of which were of Major-Three-Positive， accounting for 4.65%; 59 cases of which were of  Monior-Three-Positive， accounting for 68.60%; 23 cases of which were of other types， accounting for 26.74%. The anti-HBc has the highest positive rate among the HBV markers， accounting for 98.84%; followed by HBsAg， accounting for 79.07%; HBeAg has the lowest positive rate，  accounting for only 5.81%.  Conclusion： Among the voluntary blood donors， most of them were” Minor-Three-Positive”，  in which virus replication stops， but there is still a risk of viral transmission during blood transfusion. Chemiluminescence quantitative test， can overcome the shortcomings enzyme-linked immunoassay， providing objective explanations for hepatitis B reactive blood donors.

Key words： Chemiluminescence; Hepatitis B virus; HBV markers;

【中图分类号】R543【文献标识码】A【文章编号】1672-3783（2020）11-33--01

中国是乙型肝炎病毒（HBV）高发区，感染人数逐年递增。在国家法定检测的4项经血传播病毒中，HBV的报废率一直很高。这其中与检测方法、试剂的局限性有一定关系。2019版《血站技术操作规程》中首次将化学发光法作为血清学检测方法提出。本文旨在探讨化学发光法在无偿献血标本乙肝病毒检测方面的应用，为下一步推广提供理论依据。

1 资料与方法

1.1 一般资料 选取2017年9月至2018年11月期间，经酶联免疫吸附试验检测呈反应性的120例无偿献血标本，用化学发光法进行乙肝两对半定量检测。

1.2 方法 取献血者静脉血5mL，充分离心后取上层血浆，采用化学发光免疫分析技术，对乙肝表面抗原、乙肝表面抗体、e抗原、e抗体、核心抗体进行定量检测。……