4种不同方法在献血者梅毒检测中的应用  

The application of four different methods in the detection of syphilis in blood donors

作　　者：陈邦锐[1] 许婷婷[1] 张红[1] 乐淼[1] CHEN Bangrui;XU Tingting;ZHANG Hong;YUE Miao(Wuhan Blood Center,Wuhan,Hubei 430030,China)

机构地区：[1]武汉血液中心,湖北武汉430030

出　　处：《检验医学与临床》2022年第7期898-901,共4页Laboratory Medicine and Clinic

基　　金：湖北省武汉市卫生健康委员会医学科研项目(WG18Z06)。

摘　　要：目的制订合适的血液梅毒筛查策略。方法2018年1-6月该地区采集的78997份标本采用两种不同的梅毒酶联免疫吸附试验(ELISA)试剂检测,共检出331份梅毒ELISA初筛阳性的标本(包括双试剂阳性标本227份,单试剂阳性标本104份),再进行梅毒螺旋体明胶凝集试验(TPPA)、金标试纸条、快速血浆反应素试验(RPR)检测,以TPPA为金标准,比较各方法之间的检测结果差异。结果梅毒初筛ELISA单试剂阳性标本104份,TPPA检出3份阳性,金标试纸条检出1份阳性,RPR检出1份阳性,其余为阴性;梅毒初筛ELISA双试剂阳性标本227份,TPPA检出209份阳性,金标试纸条检出192份阳性,RPR检出39份阳性。结论梅毒ELISA试剂存在一定比例的假阳性,尤其是单试剂阳性,所以有必要进行确证试验,为献血者归队策略提供数据支持;另外建议献血前加做梅毒金标试纸条初筛,可有效降低因梅毒假阳性导致的血液报废;最后TPPA确证为阳性的标本,可补充RPR试验,以有效判断献血者所处的感染状态,便于接受献血者的试验咨询。Objective To develop appropriate blood screening strategy for syphilis.Methods From January to June 2018,78997 blood samples were collected for donation in Wuhan.Two different syphilis ELISA reagents were used to detect the samples,331 samples were positive.Then treponema pallidum gelatin agglutination test(TPPA),gold standard test strip and rapid plasma reagin test(RPR)were used to detect the 331 samples.TPPA postive was used as the gold standard to compare the detection characteristics of each method.Results Among 104 positive samples of single reagent ELISA,TPPA positive was detected in 3 cases,gold standard test strip positive was detected in 1 case,RPR positive was detected in 1 case,the rest were negative.Among 227 positive samples of double reagent ELISA,TPPA positive was detected in 209 cases,gold standard test strip positive was detected in 192 cases,and RPR positive was detected in 39 cases.Conclusion Syphilis ELISA reagent has a certain proportion of false positive,especially single reagent positive,so it is necessary to make confirmatory test to provide data support for the strategy of blood donors returning.In addition,it is suggested to do syphilis gold standard test strip screening before blood donation,which could effectively reduce the blood waste caused by syphilis positive.Finally,the samples confirmed as positive by TPPA could supplement RPR test,which could effectively judge the infection status of blood donors,which is convenient for the consultation and reply to blood donors.

关 键 词：献血者 梅毒 酶联免疫吸附试验 梅毒螺旋体明胶凝集试验 快速血浆反应素 

分 类 号：R446.6[医药卫生—诊断学]