梅毒血清学检测中RPR前带现象发生率及其与CMIA的相关性研究

Incidence of RPR prozone phenomenon in syphilis serologic testing and its correlation with CMIA

目的探讨在梅毒血清学检测中快速血浆反应素试验(RPR)前带现象的发生率及与化学微粒子发光法(CMIA)结果强度的相关性。方法应用化CMIA、明胶凝集试验(TPPA)及RPR对2014年1月至2015年12月同济医院101 493例患者进行梅毒血清学检测,评估其RPR试验中前带现象的发生率,应用逻辑回归探讨其影响因素。结果 101 493份血清标本中,CMIA检测阳性2 180例,RPR检测阳性767例,其中RPR前带现象的发生率为3.3%(26/767)。Logistic回归结果显示,RPR前带现象的发生率与CMIA的样本吸光度值比临界值、RPR滴度明显相关,而与年龄、性别及季节性无相关性。结论在梅毒血清学检测时,RPR前带现象的发生率虽然较低,但应给予足够重视。CMIA试验S/CO值较高的患者,其RPR前带现象的发生率较高。

Objective To investigate the incidence of prozone phenomenon of rapid plasma reagin（RPR）test in syphilis serologic testing and its correlation with the intensity of chemiluminescent microparticle immunoassay（CMIA）results.Methods A total of101 493 patients in our hospital from January 2014 to December 2015 were performed syphilis serologic testing by CMIA,RPR and treponema pallidum particle agglutination（TPPA）.The incidence rate of prozone phenomenon in RPR testing was evaluated.Its influencing factors were investigated by using the Logistic regression.Results Among 101 493 serum samples,2 180 cases were positive by CMIA and 767 cases were positive by RPR,the incidence rate of prozone phenomenon was 3.3%（26/767）in RPR.The Logistic regression results indicated that the incidence of prozone phenomenon was significantly correlated with CMIA S/CO values and RPR titer,but had no correlation with sex,age and seasonality.Conclusion Although the incidence of prozone phenomenon is low in syphilis serologic testing,but it is enough important.The patients with higher S/CO value in CMIA test have a higher incidence rate of RPR prozone phenomenon.