几种梅毒螺旋体检测方法在献血者血液筛查中的效果评价

Comparison of four kinds of syphilis testing methods in blood donations

目的比较快速血浆反应素环状卡片试验(RPR)、梅毒螺旋体抗体双抗原夹心酶联免疫吸附法(TP-ELISA)、梅毒螺旋体特异抗体颗粒凝集法(TPPA)、梅毒螺旋体特异抗体红细胞凝集法(TPHA)4种梅毒检测方法,选择一种适合血站献血者血液梅毒筛查的模式。方法以RPR和TP-ELISA法对献血者血液标本进行TP感染的初筛检测,再采用TPHA或TPPA微量血凝法进行复检确认,分析初复检试剂检测效果。结果RPR与TPHA检测58586份标本,结果显示二者的阳性符合率为81%(267/331),RPR法漏检64例,漏检率0.11%,出现假阳性22例,假阳性率0.04%,两种检测方法的阳性检出率差异有统计学意义;ELISA和TPPA检测18206份标本,二者的阳性检出符合率为98.2%(109/111),差异无统计学意义(P>0.05);ELISA法有2例漏检,漏检率为0.01%,出现假阳性5例,假阳性率0.027%;TPHA和TPPA检测结果差异无统计学意义。结论采用ELISA初筛,TPHA或TPPA复检模式对血液TP感染进行筛查,效果明显,值得推广。

Objective To compare four kinds of syphilis examination methods, RPR,TP-ELISA,TPHA and TPPA and to choose a suitable model for screening syphilis in blood donors. Methods RPR and TP-ELISA were used to screen samples of blood donors for treponema pallidum（TP） infection. TPHA and TPPA as the confirm methods were further tested all samples of blood donors. Results Of 58586 samples of blood donors, RPR and TPHA positive samples were 289 and 331 respectively,and the positive coincidence rate was 81% （267/331）. 64 sam ples were undetected and 22 samples were false positive by TP-ELISA. The false-negative rate and false-postive rate of RPR methods were 0.11%,0. 024% respectively. Of 18206 samples of blood donors,TP-ELISA and TPHA positive samples were 114 and 111 respectively,and the positive coincidence rate was 98.2%（109/111）. 2 samples were undetected and 5 samples were false positive by TP-ELISA. The false-negative rate and false-postive rate of TPELISA methods were 0.01%, 0. 027% respectively. TPHA and TPPA had no difference in test results. Conclusion The combination of TP-ELISA with TPHA or TPPA to detect blood donors is an effective model for screening syphilis in blood service center.