梅毒螺旋体抗体反应性献血者感染状态评估  

Assessment of infection status in treponema pallidum antibody⁃reactive blood donors

作　　者：邹姣丽[1] 陈庆恺[1] 邓妙玲[1] 袁秋婷 苏婉兰 魏润葵 陈少彬[1] 何子毅[1] ZOU Jiaoli;CHEN Qingkai;DENG Miaoling;YUAN Qiuting;SU Wanlan;WEI Runkui;CHEN Shaobin;HE Ziyi(Dongguan Blood Center,Dongguan 523000,China)

机构地区：[1]东莞市中心血站,广东东莞523000

出　　处：《中国输血杂志》2023年第6期488-491,共4页Chinese Journal of Blood Transfusion

基　　金：东莞市社会发展科技项目(20211800905402)。

摘　　要：目的评估梅毒螺旋体特异性抗体(抗⁃TP)反应性献血者的感染状态及潜在传染性,为现行筛查策略下TP的重点防控与屏蔽提供参考。方法对2021年2—10月经2种不同的抗⁃TP ELISA试剂检测为反应性的献血者血液标本133份(其中双试剂反应性77份,单试剂反应性56份),分别采用免疫印迹法(WB)进行梅毒特异性IgM抗体(TP⁃IgM)及IgG抗体(TP⁃IgG)的确证检测和TRUST检测,分析其检测结果。结果133份标本中TP⁃IgM阳性24份(18.05%)、TP⁃IgG阳性40份(30.07%),TRUST阳性3份(2.26%);其中,77份双试剂反应性标本中TP⁃IgM阳性12份(15.58%)、TP⁃IgG阳性40份(51.95%),56份单试剂反应性标本中TP⁃IgM阳性12份(21.43%)、TP⁃IgG阳性为0,2组献血者TP⁃IgM阳性率无差异(P>0.05),而双试剂反应性标本TP⁃IgG阳性率大于单试剂反应性标本(P<0.05);另133份抗⁃TP反应标本中单TP⁃IgM阳性15份(11.28%,占TP⁃IgM总阳性数的62.50%,单试剂反应性标本中共有12份TP⁃IgM阳性,且均为TP⁃IgM阳性而TP⁃IgG阴性)、单TP⁃IgG阳性标本30份(22.56%,占TP⁃IgG总阳性数的75.00%)、TP⁃IgM及TP⁃IgG均为阴性的标本55份(41.35%),均为阳性的标本8份(6.02%)。结论抗⁃TP反应性献血者中TP⁃IgM阳性者具有传染性,但阳性率不高;单试剂反应性且单TP⁃IgM阳性者易漏检,应重点防控;双试剂反应性者中TP⁃IgM和TP⁃IgG均阴性者及单TP⁃IgG阳性者,可能为假反应性及抗体终身表达现象,对于2者的永久屏蔽建议考虑增加TP⁃IgM检测为衡量指标。Objective To evaluate the infection status and potential infectivity of Treponema pallidum specific antibody(anti⁃TP)reactive blood donors,and to provide reference for the key prevention and screening of TP under the current screening strategy.Methods From February to October 2021,133 blood donors were tested reactive by two different anti⁃TP ELISA kits(77 cases were dual⁃reagent reactive and 56 cases were single⁃reagent reactive).Syphilis specific IgM antibody(TP⁃IgM)and IgG antibody(TP⁃IgG)were detected by Western blot(WB),and TRUST was conducted.The results were analyzed.Results Of the 133 samples,24(18.05%)were positive for TP⁃IgM,40(30.07%)were positive for TP⁃IgG,and 3(2.26%)were positive for TRUST.Among them,12 cases(15.58%)were TP⁃IgM positive and 40 cases(51.95%)were TP⁃IgG positive in 77 cases of double reagent reactivity,and 12 cases(21.43%)were TP⁃IgM positive and 0 was TP⁃IgG positive in 56 cases of single reagent reactivity.There was no significant difference in the positive rate of TP⁃IgM between the two groups(P>0.05),while the positive rate of TP⁃IgG in donors with double reagent reaction was higher than that in donors with single reagent reaction(P<0.05).In addition,among the 133 anti⁃TP⁃reactive blood donors,15 cases were pos⁃itive for single TP⁃IgM(11.28%,accounting for 62.50%of the total positive number of TP⁃IgM,a total of 12 cases of TP⁃IgM positive among the single reagent reactive patients,and all of them were TP⁃IgM positive and TP⁃IgG negative);30 ca⁃ses were positive for single TP⁃IgG(22.56%,accounting for 75.00%of the total positive number of TP⁃IgG).There were 55 cases(41.35%)who were negative for TP⁃IgM and TP⁃IgG,and 8 cases(6.02%)were both positive.Conclusion The TP⁃IgM positive donors in anti⁃TP reactive blood donors are infectious,but the positive rate is not high.Those with single re⁃agent reactivity and single TP⁃IgM positive are prone to miss detection,which should be controlled.Those who were both TP⁃IgM and TP�

关 键 词：献血者 梅毒螺旋体 ELISA 免疫印迹法 传染性 

分 类 号：R457.1[医药卫生—治疗学]