心血管疾病患者梅毒血清学检测阳性结果分析

Analysis of Syphilis Positive Results by Serological Detection among Patients with Cardiovascular Disease

目的分析梅毒血清学检测阳性患者在心血管疾病患者中的分布特点,为心血管疾病的诊断、外科手术治疗和内科介入治疗中需采取的生物安全措施提供实验依据。方法采用梅毒螺旋体明胶凝集试验(TPPA)和快速血浆反应素环状卡片试验(RPR)两种方法对2008年1月至2009年5月入住我院的255例心血管疾病患者标本进行梅毒血清学检测,首先用TPPA初检,初检阳性者采用RPR复检。随机收集同时期TPPA阴性200例作为对照组。分析阳性患者的性别、年龄构成及与心血管疾病的关系。结果在255例TPPA试验阳性患者中,RPR试验复检阳性84例(32.9%),阴性171例(67.1%),其中男性RPR阳性率显著高于女性(X2=5.762,P<0.05),不同年龄组人群阳性率无显著性差异(X2=6.854,P>0.05),但65岁以上患者RPR复检阳性率显著升高(X2=8.607,P<0.01)。TPPA阳性患者中,主动脉相关疾病患病率显著高于对照组(X2=8.392,P<0.01),其中主动脉夹层与主动脉瓣疾病患病率均显著高于对照组(X2=4.435,P<0.05,X2=5.162,P<0.05)。此外,TPPA阳性患者的心力衰竭患病率也显著高于对照组(X2=4.004,P<0.05)。而各类疾病RPR阳性与RPR阴性比较均无统计学差异。结论我院住院患者梅毒血清学检测阳性率男性高于女性,且多为中老年患者。65岁以上患者RPR复检阳性率显著升高。而TPPA阳性患者中,主动脉疾病及心力衰竭患病率显著升高,提示有可能为梅毒所致。临床医生在做有创诊疗时,应作好生物安全防护。

Objective To analyze the distribution of syphilis positive patients by serological detection among patients with cardiovascular disease,therefore to provide experimental evidence for the bio-security needed in the diagnosis,surgical intervention and medical intervention therapy of cardiovascular diseases.Methods Using Treponema pallidum particle agglutination test（TPPA test） and rapid plasma regain test（RPR test）,we measured 255 patients with cardiovascular disease admitted to our hospital from January 2008 to May 2009.First,we inspected all samples with TPPA test,then re-examined TPPA-positive samples with RPR test.And,we randomly collected 200 cases of TPPA-Negative samples as the control group.Then,we analyzed the gender and age composition of syphilis-positive patients and the relationship with cardiovascular disease.Results In 255 TPPA test positive patients,84 patients were RPR test positive and 171 were negative.Male in RPR test positive patients were significantly more than female（X2=5.762,P0.05）.RPR positive rate in five age groups had no statistical significance,however,patients older than 65 years had higher RPR positive rate（X2=8.607,P0.01）.TPPA test positive patients had higher prevalence of aorta diseases（X2=8.392,P0.01;dissection of aorta vs.control：X2=4.435,P0.05,aortic valvular disease vs.control：X2=5.162,P0.05） and heart failure（X2=4.004,P0.05） than the control group（n=200）.Conclusions In the RPR test positive inpatients of our hospital,male were significantly more than female and most patients were elderly people.Patients older than 65 years had significantly higher RPR positive rate,which might involve biological false positive.In TPPA positive patients,the prevalence of aorta diseases and heart failure were significantly higher than the control group,which might be induced by syphilis.