高敏化学发光法在输血患者梅毒筛查中的应用评价  

Evaluation of HISCL in pre-transfusion screening for syphilis in patients

作　　者：杨雅琼[1] 官士珍 方琳[1] 张宏静 白雪[1] 王毅[1] YANG Yaqiong;GUAN Shizhen;FANG Lin;ZHANG Hongjing;BAI Xue;WANG Yi(Department of Clinical Laboratory,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津医院检验科,天津300211

出　　处：《中国输血杂志》2019年第4期381-383,共3页Chinese Journal of Blood Transfusion

摘　　要：目的评价高敏化学发光法(high sensitivity chemiluminescence enzyme immunoassay,HISCL)在骨科输血患者梅毒特异性抗体检测中的应用价值。方法收集本院住院及门诊患者应用HISCL和明胶颗粒凝集试验(treponema pallidum particle agglutination,TPPA)两种方法检测的样本,分析两种方法检测结果的符合率。对两种方法结果不一致的样本采用免疫印迹法(Recombinant immunoblot assay,RIBA)进行确认。采用标准血清盘进行梅毒特异性抗体血清敏感性试验。结果 HISCL法与TPPA法的阴性符合率为100%,阳性符合率97.56%,总符合率99.29%;HISCL检测结果COI值与TPPA法效价相关性分析,r=0.959,P<0.05,表明二者密切相关;以TPPA方法为确证标准,评价HISC L法的灵敏度、特异性、阳性预测值,阴性预测值分别为97.56%、100%、100%、99.01%;对两种方法检测结果不符合的6例样本采用重组免疫印迹试验(RIBA)进行确认,结果表明HISCL法与RIBA法结果的符合率(4/6)高于TPPA法(1/6);通过血清盘检测,二种方法对梅毒抗体检测的灵敏度、特异性一致。而TPPA方法相对而言操作繁琐、耗时长、结果的判读易受主观因素影响,HISCL法则是全自动检测,每个测试只需要17min就可完成。结论 HISCL与TPPA两种方法在梅毒特异性抗体筛查上性能相近,HISCL法更加适合于患者手术及输血前的快速筛查。Objective To study the clinical value of high sensitivity chemiluminescence enzyme immunoassay(HISCL)in the pre-transfusion screening for syphilis-specific antibodies in orthopedic patients.Methods Serum specimens collected from patients of in-patient and out-patient departments of our hospital were detected by HISCL and TPPA simultaneously.Consistency between the two methods were evaluated.A recombinant immunoblot assay(RIBA)test was applied as a confirmatory test when the results were not identical under these two methods.Standard blood serum panel was used to detect the sensitivity of treponema pallidum antibody.Results Between the two methods,the concordance rate of negative results and positive results were 100%and 97.56%,respectively,with the concordance rate of total results of 99.29%.The result of correlation analysis indicates the close relationship between the COI value of HISCL and the titer of TPPA(r=0.959,P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of HISCL anti-TP assay were 97.56%,100%,100%and 99.01%,respectively,with TPPA as a confirmatory test.RIBA was used to confirm the inconsistent results of 6 samples between the two methods.The concordance rate of HISCL and RIBA(4/6)was higher than the concordance rate of TPPA and RIBA(1/6).The sensitivity and specificity of the two methods are consistent via serum panel test.TPPA assay was relatively tedious,time-consuming and easily influenced by subjective factors,while HISCL anti-TP assay was fully automatic and each test can be completed in only 17 minutes.Conclusion The two methods have similar performance on the detection of treponema pallidum antibody.HISCL is more suitable for rapid screening before the operation and transfusion.

关 键 词：梅毒 HISCL法 TPPA RIBA 梅毒螺旋体特异性抗体 

分 类 号：R457.1[医药卫生—治疗学] R514[医药卫生—临床医学]