• 中国科学论文统计源期刊
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临床输血与检验

临床输血与检验 ›› 2018, Vol. 20 ›› Issue (5): 493-496.DOI: 10.3969/j.issn.1671-2587.2018.05.012

• 临床输血 • 上一篇    下一篇

92 169例拟受血患者梅毒螺旋体特异性抗体检测与分析

曹微微, 李宁, 梅城, 李碧娟, 肖超奇, 陈廷寅   

  1. 410008 长沙,中南大学湘雅医院输血科（曹微微,李宁,梅城,李碧娟,肖超奇）;
    信息科（陈廷寅）
  • 收稿日期:2018-01-17 出版日期:2018-10-20 发布日期:2018-09-27
  • 通讯作者: 通信作者;李宁,男,教授,研究生导师,主要从事输血感染与免疫血液学研究,（E-mail）nxli1970@126.com。
  • 作者简介:曹微微（1982-）,女,浙江普陀人,主管技师,硕士,主要从事临床检验和输血工作,（Tel）13548960574。

Detection and Analysis of Antibodies Against Treponema Pallidum in 92 169 Cases of Blood Recipients

CAO Wei-wei, LI Ning, MEI Chen, etal   

  1. Department of Blood Transfusion of Xiangya Hospital,Central South University,Changsha,410008
  • Received:2018-01-17 Online:2018-10-20 Published:2018-09-27

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摘要： 目的 评估化学发光微粒法（CMIA）检测梅毒螺旋体抗体的特异性,并分析不同年龄段及性别之间梅毒螺旋体阳性率的差异。方法 采用CMIA法对本院住院和门诊92 169例拟受血患者的血清标本进行梅毒螺旋体特异性抗体（抗-TP）检测,阳性标本用梅毒螺旋体明胶颗粒凝集试验（TPPA）确认。结果 CMIA法检测发现阳性2 825例,TPPA法阳性确认2 680例,CMIA筛查结果与TPPA法确认结果比较,假阳性率0.16%,阳性预测值94.87%。CMIA法S/CO值越大,经TPPA法TP阳性确认率越高;S/CO值小于2的阳性标本确认率仅为72.8%,低于其他S/CO值组;S/CO值大于5的标本,TPPA法阳性确认率为100.0%;比较各S/CO值组TPPA法获得阳性率的差异有统计学意义（χ2=138.26,P<0.001）。拟受血患者中TP感染率为2.91%;感染率随年龄的增长而增高（χ2=353.69,P<0.001）,60岁以上老年人感染率高于其他人群（χ2=206.97,P<0.001）。男性感染率为2.78%,女性为3.04%,不同性别患者病毒感染率的差异有统计学意义（χ2=4.86,P=0.027）。结论 CMIA在抗-TP检测中的灵敏度较好,适合大批量筛查。对于CMIA法检测梅毒特异性抗体阳性的标本,尤其是S/CO低值样本（S/CO为1~2）,有必要进行TPPA复检,以提高检测结果的准确性,避免临床医疗纠纷。住院和门诊拟受血患者中抗-TP阳性率随年龄增长而增高,同时老年人的假阳性率也较高,因此对老年人的梅毒试验阳性结果应慎重对待。

关键词: 梅毒螺旋体特异性抗体, 化学发光微粒子免疫分析法, 梅毒螺旋体明胶颗粒凝集试验

Abstract: Objective To evaluate the specificity of antibodies（anti-TP） to Treponema pallidum detected by chemiluminescent microparticle immunoassay （CMIA）,and to analyze TP infection in the patients before blood transfusion. Methods CMIA was used to detect the anti-TP in 92 169 cases of pre-transfusion patients. The sera with initially positive anti-TP was then confirmed by T.Pallidum particle agglutination（TPPA）. Results 2 825 serum samples were anti-TP positive by CMIA. Among them,2 680 were confirmed to be positive by TPPA assay. Compared with the TPPA assay,the false positive rate of the CMIA was 0.16%,and the positive predictive value was 94.87%. In the samples with S/CO value between 1 and 2,the seroprevalence of anti-TP was 72.8%,while in the samples with S/CO value more than 5,the seroprevalence of anti-TP was 100% when tested with TPPA,showing a significant difference among all S/CO value groups（χ2=138.26,P<0.001）. The positive rate of anti-TP antibodies increased with age （χ2=353.69,P<0.001）,and was significantly higher in elderly people over 60 years（χ2=206.97,P<0.001） . The TP infection rate in females is much higher than that in males（χ2=4.86,P=0.027）. Conclusions A part of blood recipients before transfusion have TP infection. CMIA shows high sensitivity and useful for mass screening in detection of anti-TP,but low S/CO value indicates relatively high false positive TP infection . Finding anti-TP positive samples with TPPA is necessary,especially in low S/CO value. The positive rate of anti-TP increased with age,and the false positive rate was higher in the elderly,indicating that the positive results of syphilis test in this population should be cautiously treated.

Key words: Treponema pallidum antibody, Chemiluminescent microparticle immunoassay, Treponema pallidum particle assay

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