甘肃省80018例梅毒血清学筛查及假阳性结果分析  

Serological screening for syphilis and false positive results in 80018 patients with syphilis in Gansu Province

作　　者：叶华[1] 张晓梅[1] 张兴旺[1] 马华瑜[1] YE Hua;ZHANG Xiaomei;ZHANG Xingwang;MA Huayu(Medical Laboratory Center,Gansu Provincial Hospital,Lanzhou,Gansu 730000,China)

机构地区：[1]甘肃省人民医院检验中心,甘肃兰州730000

出　　处：《医药前沿》2025年第3期8-10,共3页Journal of Frontiers of Medicine

摘　　要：目的 分析住院患者的梅毒血清学筛查结果,比较不同方法、不同性别及不同年龄段之间梅毒阳性率及假阳性率的差异,并探讨假阳性出现的原因及意义。方法 采用酶联免疫吸附法(ELISA)、微粒子化学发光法(CMIA)对2022年6月—2023年12月在甘肃省人民医院住院的80 018例患者进行梅毒螺旋体特异性抗体(TPAb)筛查,初筛阳性样本用梅毒螺旋体明胶颗粒凝集试验(TPPA)确认,比较两种试验方法、不同性别及不同年龄段之间梅毒阳性率及假阳性率的差异。结果 ELISA法检测TPAb阳性率为1.79%,高于CMIA法检测的阳性率(1.18%),差异有统计学意义(P<0.05)。两种初筛方法检测的TPAb假阳性率比较,差异无统计学意义(P>0.05)。男性TPAb阳性率为1.49%,高于女性TPAb阳性率(1.25%),差异有统计学意义(P<0.05)。男性和女性的TPAb假阳性率比较,差异无统计学意义(P>0.05)。60岁以上老年人群TPAb阳性率和假阳性率与其他两组比较差异均有统计学意义(P<0.05)。内分泌系统疾病、心血管系统疾病、恶性肿瘤在105例梅毒假阳性患者中占比较高。结论 ELISA法与CMIA法在梅毒检测中都存在假阳性情况,假阳性率在60岁以上老年人群中较高,实验室需通过TPPA试验进行确证。临床中对老年人TPAb结果应进行综合分析后慎重做出判断,尽量避免梅毒化验结果假阳性造成的误诊。Objective To analyze the results of syphilis serological screening in inpatients,to compare the differences of positive rate and false positive rate between different methods,different genders and different age groups,and to explore the causes and significance of false positive.Methods Enzyme-linked immunosorbent assay(ELISA)and chemiluminescence microparticle immunoassay(CMIA)were used to screen treponema pallidum antibody(TPAb)in 80018 inpatients in Gansu Provincial Hospital from June 2022 to December 2023.The positive samples of primary screening were confirmed by treponema pallidum particle agglutination test(TPPA)test.The differences of syphilis positive rate and false positive rate between the two methods,different genders and different age groups were compared.Results The positive rate of TPAb detected by ELISA was 1.79%,which was higher than 1.18%by CMIA,and the difference was statistically significant(P<0.05).There was no significant difference in the false positive rate of TPAb detected by two primary screening methods(P>0.05).The positive rate of TPAb in males(1.49%)was higher than that in females(1.25%),and the difference was statistically significant(P<0.05).There was no significant difference in the false positive rate of TPAb between males and females(P>0.05).The positive rate and false positive rate of TPAb in the elderly group over 60 years old were significantly different from those in the other two groups(P<0.05).Endocrine system diseases,cardiovascular system diseases and malignant tumors accounted for a relatively high proportion in the 105 patients with false positive syphilis.Conclusions Both ELISA and CMIA methods have false positive results in the detection of syphilis,and the false positive rate is higher in the elderly population over 60 years old.TPPA test is needed to confirm the results.In clinical practice,the results of treponema pallidum antibody in the elderly should be comprehensively analyzed before making a judgment so as to avoid misdiagnosis caused by false positive results

关 键 词：梅毒 梅毒螺旋体 血清学 筛查 酶联免疫吸附试验 化学发光法 假阳性 凝集试验 

分 类 号：R759[医药卫生—皮肤病学与性病学]