2019年深圳地区无偿献血者梅毒筛查结果分析  

Analysis of TP screening results among voluntary blood donors in 2019,Shenzhen

作　　者：曾雪珍[1] 赵俊鹏 陈云龙[1] 杜丹丹[1] 邬林枫[1] 李然 崔秀娟[1] 曾劲峰[1] ZENG Xuezhen;ZHAO Junpeng;CHEN Yunlong;DU Dandan;WU Linfeng;LI Ran;CUI Xiujuan;ZENG Jinfeng(Shenzhen Blood Center,Shenzhen 518035,China)

机构地区：[1]深圳市血液中心,广东深圳518035

出　　处：《中国输血杂志》2020年第10期1083-1086,共4页Chinese Journal of Blood Transfusion

摘　　要：目的分析2019年深圳地区无偿献血者梅毒(TP)筛查情况,为评估无偿献血人群梅毒感染风险提供依据。方法采用丽珠和索林的梅毒螺旋体抗体诊断试剂盒(ELISA法)对2019年深圳市无偿献血者标本进行筛查,梅毒抗体反应性标本送至深圳市慢性病防治院进行TRUST检测及TPPA确证试验,TPPA阳性或滴度为1∶80,则结果反馈为梅毒确证阳性。结果2019年深圳地区无偿献血者全血或血小板标本检测量共计122103人份,梅毒ELISA筛查反应性标本714例(丽珠反应性:154例,索林反应性:217例,丽珠-索林反应性:343例),TP不合格率为0.59%(714/122103),不合格标本确证阳性率为40.9%(292/714),综上TP流行率为0.24%(292/122103)。确证阳性标本中97.6%(285/292)为丽珠-索林反应性,2.4%(7/292.丽珠反应性:3,索林反应性:4)为单试剂反应性。TP确证阴性的标本S/CO值均值为2.435±0.210,阳性标本S/CO值均值为11.346±0.500(P<0.01)。深圳地区TP阳性献血者36-55岁占比58.9%(172/292),主要职业为职员或工人(36.3%,106/292),高中及以下学历比例超过70%。结论深圳市血液中心无偿献血者TP双试剂反应性阳性预测值及ELISA S/CO值高于TP单试剂反应性献血者标本;TP确证阳性中有一定比例ELISA单试剂反应性S/CO低值标本,揭示我国使用2种试剂进行献血者梅毒筛查具有科学性,有利于降低梅毒经输血感染的风险;TP阳性预测值较低,ELISA的非特异反应造成血液资源的浪费,需要加强对血液筛查实验室检测质量的管理,探究更合理的TP筛查策略;深圳地区TP阳性献血者主要为36—55岁职工或工人,教育水平较低,应加强对低危群体献血者的招募及高危献血人群的献血前征询,以及增加重复献血者在献血人群中的比率。Objective To analyze the screening results of treponema pallidum(TP)antibodies among voluntary blood donors in Shenzhen in 2019,aimed to provide references for determining risk factors associated with syphilis infection among blood donors.Methods Livzon and Sorin′s anti-TP diagnostic kit(ELISA method)was used to screen the samples of voluntary blood donors in Shenzhen throughout 2019,and the anti-TP reactive samples were sent to Shenzhen Chronic Disease Prevention and Treatment Institute for TRUST detection and TPPA confirmation test.Samples that were positive for TPPA or with the titer as 1∶80 were confirmed as syphilis positive.Results In 2019,a total of 122103 whole blood or platelet samples from voluntary blood donors in Shenzhen were tested for TP antibody.Among them,714 were reactive for anti-TP by ELISA(Livzon reactivity in 154 cases,Sorin reactivity in 217 cases,and Livzon-Sorin reactivity in 343 cases),with a syphilis deferral rate at 0.59%(714/122103),and 40.9%(292/714)of the syphilis deferral were confirmed to be anti-TP true positive.The overall prevalence of TP was 0.24%(292/122103).Among the confirmed positive samples,97.6%(285/292)were Livzon-Sorin reactivity,and 2.4%were single-agent reactivity(Livzon Reactivity and Sorin reactivity constituted 3 and 4 cases,respectively).The mean S/CO value of TP-negative and TP-positive samples was 2.435±0.210 vs 11.346±0.500(P<0.01).In Shenzhen,the seroprevalence of syphilis was mainly observed among age group of 36—55 years(58.9%,172/292),staff or daily labourers(36.3%,106/292)and education level as senior high school or below(over 70%).Conclusion For blood donors from Shenzhen Blood Center,the positive predictive value(PPV)and ELISA S/CO value of donations reactive to two TP assays are higher than those reactive to one TP assay.The current duplicate-assay screening strategy over syphilis in China contributes to minimize the risk of syphilis infection through blood transfusion considering the presence of one-ELISA-assay reactive samples with low S/CO v

关 键 词：无偿献血者 梅毒螺旋体(TP) 酶联免疫吸附试验(ELISA) 确证试验 

分 类 号：R457.1[医药卫生—治疗学] R446.6[医药卫生—临床医学]