时间分辨荧光免疫法筛查低危人群梅毒螺旋体抗体分析

Analysis of Time-resolved Fluorescence Immunoassay Method in Screening Treponema Pallidum Antibody in LowRisk Populations

目的分析时间分辨荧光免疫法用于低危人群梅毒螺旋体抗体筛查的结果,研究其适用性和流程。方法采用时间分辨免疫荧光法(TRFIA)检测住院患者血清中梅毒螺旋体抗体含量,TRFIA阳性标本用梅毒螺旋体明胶颗粒凝集试验(TPPA)确认。二者不符者用荧光密螺旋体抗体吸收试验(FTAABS)验证。结果 15 786例住院患者血清标本中,TRFIA法筛查阳性317例(2.01%),其S/CO值中位数为20.61(9.48,33.55)。筛查阳性标本经TPPA确认,阳性284例,保留2例。33例结果不一致标本经FTA-ABS验证,1例TP-Ig M阳性(TPPA为保留),2例TP-Ig G阳性。随机抽取TRFIA筛查阴性标本253例,TPPA验证皆阴性。TRFIA法对梅毒螺旋体抗体检测的敏感性和特异性分别为100%和89.08%。结论 TRFIA法适合作为低危人群梅毒螺旋体抗体的筛查方法,可结合TPPA等确诊方法进行结果判断,不一致标本可用蛋白印迹技术或FTA-ABS法第三方验证,或者随访后再次检测。

Objective To explore the applicability of TRFIA method in screening treponema pallidum antibody in lowrisk populations. Methods The contents of treponema pal-lidum antibody in serums of patients during hospitalization were detected by TRFIA. TRFIA positive specimens were confirmed by treponema pallidum gelatin particle agglutination test（ TPPA）. The inconsistent ones were verified by fluorescent treponemal antibody absorption test（ FTA- ABS）. Results In results of 15 786 hospitalized patients serum specimens,The TRFIA positive rate was 2. 01%（ 317 /15786）,the positive S / CO value median was 20. 61（ 9. 48,33. 55）. Among TRFIA positive specimens,284 cases（ 89. 60%） were confirmed positive by TPPA,2cases were suspicious. Among 33 inconsistent specimens verified by FTA-ABS,one case is TP-Ig M positive,two cases were TP-Ig G positive. 253 TRFIA negative samples were randomly selected,were confirmed negative by TPPA. For screening of syphilis antibody in low-risk populations,the sensitivity and specificity of TRFIA are 100% and 89. 08%. Conclusion The TRFIA method is suitable as a syphilis antibody screening method in low-risk populations of treponema pallidum,combining with TPPA diagnosis methods,such as the judgement results. Inconsistent specimens can be verified by Western blotting or FTA-ABS,or follow-up and retest.