某医院住院患者梅毒筛查情况分析

Analysis of syphilis screening in hospitalized patients in a hospital

目的探讨2017-01~6期间延安大学附属医院东关心脑血管分院住院患者中梅毒的发病情况,分析化学发光法在梅毒抗体检测中的应用价值。方法用化学发光法对住院患者进行梅毒抗体初筛,阳性者进一步做梅毒螺旋体明胶颗粒凝集试验(TPPA)和快速血浆反应素环状卡片试验(RPR),分析该院住院患者中梅毒的检出情况,及两种检测方法的符合率。结果 9092例住院患者化学发光法阳性256例(2. 82%),与TPPA符合率为94. 92%;其中RPR滴度小于或等于1∶2有216例(占化学发光法84. 38%)。小于20岁组、小于30岁组检出率仅为0. 63%、0. 66%,30岁以上至70岁以下年龄组分别是1. 29%、3. 63%、2. 90%、2. 57%,而70~80岁和80岁以上年龄组老年人的检出率3. 42%、4. 49%。几乎全部临床科室均有梅毒筛查阳性病例,其中综合内科、重症医学科、综合外科、神经内科的阳性率分别为3. 57%、3. 44%、3. 20%、3. 01%,明显高于其他科室住院患者的平均检出水平。结论梅毒血清学试验化学发光法联合TPPA和RPR是目前临床诊断最常用且有效的梅毒筛查试验。

Objective To investigate the incidence of syphilis in hospitalized patients in Dongguan cardiovascular and cerebrovascular branch of Affiliated Hospital of Yan＆apos;an University from January 2017 to June, and to analyze the application value of chemiluminescence method for syphilis antibody detection. Methods The syphilis antibody was screened by chemiluminescent method. The syphilis Treponema pallidum particle agglutination test （TPPA） and the rapid plasma reagin ring card test （RPR） were performed on the positive patients, the prevalence of syphilis in hospitalized patients and the coincidence rate of the two Methods were analyzed. Results In 9092 hospitalized patients, 256 cases （2.82%） were positive for chemiluminescence, and the coincidence rate with TPPA was 94.92%, of which 216 cases were RPR titers less than or equal to 1：2, accounting for 84.38% of chemiluminescence method. The detection rate of group less than 20 years old and less than 30 years old group is only 0.63% and 0.66%. The age group from 30 to 70 years old is 1.29%, 3.63%, 2.90% and 2.57%, respectively. Almost all clinical departments had positive cases of syphilis screening. The positive rates of comprehensive internal medicine, critical care medicine, general surgery and neurology were 3.57%, 3.44%, 3.20%, 3.01%, respectively, which were significantly higher than those of other departments. Conclusion Syphilis Serological Test chemiluminescence combined with TPPA and RPR is the most common and effective screening test for syphilis at present.