梅毒抗体筛检不合格献血者的梅毒确认及梅毒感染状况分析  

Syphilis Confirmatory Testing and Syphilis Infection Status Analysis of the Blood Donors on the Unqualified Results of Anti-TP Antibody Screening

作　　者：胡晓玉[1] 吴学忠[1,2,3] 程卫芳 金惠新[1] 鲁晋[1] 吴君胜 尹萍[1] 郭晓婕 魏家余 张恒萍 HU Xiao-yu;WU Xue-zhong;CHENG Wei-fang(Anhui Blood Center,Hefei 230031)

机构地区：[1]安徽省血液中心,230032 [2]安徽医科大学公共卫生学院 [3]淮南市第一人民医院输血科

出　　处：《临床输血与检验》2020年第2期142-147,共6页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：合肥市卫生计生委2016年应用医学研究项目(No.hwk2016zc019);安徽省血液中心科研项目(No.2015AHBC02)资助。

摘　　要：目的 对梅毒抗体筛检不合格献血者的梅毒确认及梅毒感染状况分析,为科学合理地设置灰区、献血者告知与屏蔽提供参考。方法 收集安徽省血液中心2016年3月24日~10月2日用酶联免疫吸附试验(ELISA)进行梅毒抗体筛检不合格献血者标本290份,采用梅毒螺旋体颗粒凝集试验(TPPA)对梅毒抗体筛查不合格献血者标本进行梅毒确认试验,采用TRUST进行凝集滴度检测。结果 290份梅毒抗体筛查不合格献血者标本经TPPA确认有166份TPPA阳性和124份TPPA阴性,TPPA阳性标本经甲苯胺红不加热血清试验(TRUST)有50份TRUST阳性和116份TRUST阴性。梅毒-ELISA筛检试剂一、试剂二的阳性检出率差异无统计学意义(P>0.05)。梅毒-ELISA筛检单试剂阳性及双试剂灰区共计107份标本经TPPA确认检测,未检测出TPPA阳性。梅毒抗体筛检不合格献血者中,男性TPPA阳性率(57.31%)与女性TPPA阳性率(57.14%)无明显差别(P>0.05),已婚者TPPA阳性率(68.78%)明显高于未婚者(35.64%)(P<0.05),男性已婚者TPPA阳性率(70.18%)明显高于男性未婚者(31.58%)(P<0.05),女性已婚者TPPA阳性率(66.67%)高于女性未婚者(40.91%)(P<0.01)。献血1次者TPPA阳性率(61.07%)高于献血2次及以上者(21.43%)(P<0.05),不同教育背景之间TPPA阳性率之间差异较明显(P<0.05),ABO血型系统中不同血型之间TPPA阳性率无明显差异(P>0.05)。结论 梅毒抗体ELISA筛检试验存在一定比例假阳性,为了避免弱阳性标本的漏检,血液筛检实验室应对试验性能进行监控,科学合理地设置灰区,减少不必要的血液浪费。为了更好地做好献血者告知和减少献血者流失,建立持续稳定的献血队伍,建议血站对梅毒抗体筛检不合格献血者标本加做梅毒确认试验,参考确证结果进行献血者信息反馈,并作为是否屏蔽筛检不合格献血者的判定依据。梅毒抗体筛检不合格献血者中尤其已婚及低教育背景者梅毒感染率较高,针对TPPA�Objective Syphilis confirmatory testing and syphilis infection status analysis of the blood donors on the unqualified results of anti-TP antibody screening,in order to provide the reference of setting the scientific and reasonable grey area and informing the test results of the blood donors and shielding the blood donors.Methods From 24 March to 2 October in 2016,290 blood samples of the blood donors on the unqualified results of screening anti-TP antibody were collected in Anhui blood center.Syphilis confirmation was performed by TPPA and the agglutination titer of the Non-treponema pallidum antibody was detected by TRUST.Results 290 unqualified samples of anti-TP antibody screening were confirmed by TPPA,there were 166 TPPA positive samples and 124 TPPA negative samples.There were 50 TRUST positive samples among 166 TPPA positive samples.The positive rate of anti-TP ELISA screening reagent 1 and reagen 2 showed no significant difference(P>0.05).There wasn't TPPA positive samples among 107 samples with single reagent positive and double reagent grey area for anti-TP antibody ELISA screening.Among 290 unqualified samples of anti-TP antibody screening,there was no significant difference(P>0.05)between male TPPA positive rate(57.31%)and female TPPA positive rate(57.14%),there was significant difference that the married persons TPPA positive rate(68.78%)was higher than the unmarried persons its(35.64%)(P<0.05),the married males TPPA positive rate(70.18%)was higher significantly than the unmarried males(31.58%)(P<0.05),the married females TPPA positive rate(66.67%)was higher significantly than the unmarried females TPPA positive rate(40.91%)(P<0.01),the TPPA positive rate of the once blood donors(61.07%)was higher significantly than its of 2 times and above 2 times blood donors(27.27%)(P<0.05),the TPPA positive rate of the different education background persons had significant difference(P<0.05),the TPPA positive rate of the different ABO blood group persons had no significant difference(P>0.05).Conclusion The anti-T

关 键 词：献血者 梅毒螺旋体 抗体滴度 确认试验 献血者屏蔽 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]