梅毒血清反应假阳性的影响因素  

Influencing factors of false-positive serological reaction of syphilis

作　　者：田晓波[1] 金静[1] 文江平[1] 吴薇[1] 刘向祎[1] Tian Xiaobo;Jin Jing;Wen Jiangping;Wu Wei;Liu Xiangyi(Department of Clinical Medicine,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院检验科,100176

出　　处：《中华传染病杂志》2021年第4期224-227,共4页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金(81371861)。

摘　　要：目的探讨梅毒血清反应假阳性的影响因素。方法纳入2017年1月至2020年2月首都医科大学附属北京同仁医院梅毒血清反应假阳性患者166例(假阳性组),诊断为早期梅毒且未经治疗的患者145例(阳性对照组),入职体检者124名(阴性对照组)。比较3组研究对象的性别、年龄和合并基础疾病情况,采用logistic回归分析梅毒血清反应假阳性的影响因素。比较化学发光免疫分析法(chemiluminescence immunoassay,CLIA)与甲苯胺红不加热血清试验(toluidine red unheated serum test,TRUST)的梅毒血清试验效能。统计学处理采用配对样本t检验或χ^(2)检验。结果166例假阳性组患者中,年龄≥50岁117例,年龄<50岁49例。假阳性组与阴性对照组比较,年龄[(53.1±13.8)岁比(24.7±2.8)岁,t=22.56,P<0.01]、自身免疫病[36.7%(61/166)比6.5%(8/124),χ^(2)=35.93,P<0.01]、肝炎[9.6%(16/166)比3.2%(4/124),χ^(2)=4.92,P=0.026]和肿瘤[6.6%(11/166)比0.8%(1/124),χ^(2)=4.68,P=0.030]差异均有统计学意义;假阳性组与阳性对照组比较,性别[假阳性组男91例(54.8%),女75例(45.2%),阳性对照组男103例(71.0%),女42例(29.0%);χ^(2)=8.67,P=0.003]、年龄[(53.1±13.8)岁比(34.4±12.9)岁,t=20.13,P<0.01]及自身免疫病[36.7%(61/166)比6.9%(10/145),χ^(2)=39.14,P<0.01]差异均有统计学意义。多因素logistic回归分析显示,性别[比值比(odds ratio,OR)=2.692,95%可信区间(confidence interval,CI)1.504~4.816,P=0.001]、年龄≥50岁(OR=30.512,95%CI 15.959~58.335,P<0.01)、自身免疫病(OR=2.677,95%CI 1.258~5.695,P=0.011)和肝炎(OR=4.408,95%CI 1.799~10.799,P=0.001)是梅毒血清假阳性的影响因素。假阳性组中,TRUST的阳性率为84.9%(141/166),高于CLIA的23.5%(39/166),差异有统计学意义(χ^(2)=126.25,P<0.01);36例患者CLIA为1.0~10.0临界指数(cut off index,COI),3例患者CLIA>10.0 COI,差异有统计学意义(χ^(2)=52.51,P<0.01);139例患者TRUST≤1∶4阳性,2例患者TRUST≥1∶8阳性,差异有统计学意义(χ^(2)=262.35,P<Objective To explore the influencing factors of false-positive serological reaction of syphilis.Methods A total of 166 patients with false-positive serological reaction of syphilis(false-positive group),145 patients diagnosed with early syphilis without treatment(positive control group)and 124 persons undergoing entry physical examination(negative control group)were included from January 2017 to February 2020 in Beijing Tongren Hospital,Capital Medical University.The gender,age and underlying diseases of the three groups were compared.Logistic regression was used to analyze the influencing factors of false-positive serological reaction of syphilis.The efficacies of chemiluminescence immunoassay(CLIA)and toluidine red unheated serum test(TRUST)were compared.Paired t test or chi-square test was used for statistical analysis.Results In the false-positive group(166 cases),the age of 117 cases were more than 50 years old and 49 cases<50 years old.There were significant differences in age((53.1±13.8)vs(24.7±2.8),t=22.56,P<0.01),autoimmune disease(36.7%(61/166)vs 6.5%(8/124),χ^(2)=35.93,P<0.01),hepatitis(9.6%(16/166)vs 3.2%(4/124),χ^(2)=4.92,P=0.026)and tumor(6.6%(11/166)vs 0.8%(1/124),χ^(2)=4.68,P=0.030)between the false-positive group and the negative control group.There were significant differences in gender(there were 91(54.8%)males and 75(45.2%)females in the false-positive group,and 103(71.0%)males and 42(29.0%)females in the positive control group,χ^(2)=8.67,P=0.003),age((53.1±13.8)vs(34.4±12.9),t=20.13,P<0.01)and autoimmune disease(36.7%(61/166)vs 6.9%(10/145),χ^(2)=39.14,P<0.01)between the false-positive group and the positive control group.Multivariate logistic regression analysis showed that gender(odds ratio(OR)=2.692,95%confidence interval(CI)1.504-4.816,P=0.001),age≥50 years old(OR=30.512,95%CI 15.959-58.335,P<0.01),autoimmune disease(OR=2.677,95%CI 1.258-5.695,P=0.011)and hepatitis(OR=4.408,95%CI 1.799-10.799,P=0.001)were the influencing factors of false-positive serological reaction of syphili

关 键 词：梅毒 假阳性反应 影响因素 非梅毒特异性抗体 

分 类 号：R514[医药卫生—内科学]