精品通过输血所传播的疾病的流行病学课件

输血传播疾病的流行病学 Sharyn Orton MT(ASCP)SBB, MSPH,PhD.candidate 译者:girlning 一般情况 每年有8百万献血者 可获得1千4百万单位的血 可获得2千3百万的血液成分 每年有4百万的患者 安全措施 志愿者献血 献血前的教育 献血史的检查和问卷调查 血清学检测 可信成分的排除 反馈 血制品检测 ABO,Rh血型和抗体筛查 乙肝表面抗原 乙肝核心抗体 丙肝抗体 抗人白血病/型抗体 梅毒血清学实验 血制品检测 艾滋病病毒1/2型抗体检测 艾滋病病毒p24抗原 谷丙转氨酶 巨细胞病毒抗体(选作) 丙肝RNA(1999年新加入) 艾滋病病毒RNA(1999年新加入) 献血者类型 异基因献血者 直接献血 自体输血 血液成分的单采 输血传播的感染性疾病的可能性 献血者的血清学检测以计算发病率 窗口期的持续时间 感染性疾病在献血者中的发病率 丙肝 4.32 艾滋病病毒1/2 3.37 乙肝 9.8 人白血病相关病毒/ 1.12 各种病毒的窗口期 丙型肝炎病毒 23天 人类免疫缺陷病毒 11天 乙型肝炎病毒 59天 人白血病相关病毒 51天 输血传播的感染性疾病的危险性 丙肝 2.27/百万献血者 艾滋病 1.01/百万献血者 乙肝 6.65/百万献血者 人白血病相关病毒 1.56/百万献血者 丙肝的流行病学 世界范围内不同基因型流行率不同 初步筛选5-10%的受血者患输血相关性肝炎 目前有0.1%的输血相关性肝炎 降低输血传播的感染性疾病的方法 灭菌 保存血浆 去白细胞 减少暴露 使用自体血 严格控制输血标准,尽量减少输血 药物治疗患者 重组血浆制品 潜在的寄生虫感染 疟疾 巴贝虫病 弓形虫 恰加斯病 利什曼病 输血传播病毒中的新病毒 庚型肝炎病毒 输血传播的肝炎病毒 朊病毒 KS相关的HHV-8型病毒 MS相关的逆转录病毒 献血者血清病毒的流行率 HGV RNA 1-3% HGVE2抗体 10% TT病毒 ? CJD ? 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