184例梅毒检验假阳性及假阴性的调查研究

Investigation of false positive and false negative in 184 cases of syphilis

目的研究184例梅毒检验假阳性及假阴性的原因及影响因素,为提高临床梅毒诊断准确率提供参考。方法选取2012年11月至2017年11月鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)诊治的2536例梅毒筛查患者作为研究对象。其中出现假阳性及假阴性患者共184例,按照检验符合情况将2536例患者分为三组,即对照组(真阳性+真阴性)2352例,假阳性组88例、假阴性组96例。对比三组受检者的临床资料,按照受检前1个月抗菌药物应用频次、人员操作、设备设施、试剂试液、标准处理和相关疾病等6方面因素分析原因。结果 2536份标本中,184例检验结果出错,假阳性组及假阴性为7.3%。假阳性组患者受检前1个月抗菌药物应用频次、相关疾病发生率、标准处理失误率明显高于假阴性及对照组组,差异具有统计学意义(P<0.05),且对照组与假阴性组对比,差异无统计学意义(P>0.05)。假阴性组患者人员操作、设备设施、试剂试液等系统误差率明显高于假阳性组及对照组,差异具有统计学意义(P<0.05),且假阳性组与对照组对比,差异无统计学意义(P>0.05)。结论梅毒检验结果的准确性受到人员操作、设备设施、试剂试液、标准处理和相关疾病等多方面因素的影响,实际检验中可针对性地设计预防方案,提高检验结果的准确性。

Objective To study the causes and influencing factors of false positive and false negative in 184 cases of syphilis, so as to provide reference for improving the accuracy of clinical syphilis diagnosis. Methods 2536 syphilis screening patients in our hospital from November 2012 to November-2017 were collected, including 184 false positive and false negative patients. According to the test compliance, the patients were divided into three groups, namely the control group(true positive and true negative), false positive group and false negative group. The clinical data was compared between the three groups and analyzedin terms of the 6 areas ofantibioticsmedication frequency, personnel operation, equipment and facilities, reagent, standard treatment and disease related. Results In the 2536 samples, 184 cases were diagnosed wrong, with a false positive and false negative rate of 7.3%. The antibiotics medication frequency,incidence of related diseases and standard treatment failure rate in the false positive group were significantly higher than those in the false negative group and the control group, with statistically significant differences(P<0.05), and there was no significant difference between the control group and the false negative group(P>0.05). The system error rate of personnel operation, equipment and facilities, and reagent of false negative group were significantly higher than those of the false positive group and the control group, with statistically significant differences(P<0.05), and there was no significant difference between the control group and the false positive group(P>0.05). Conclusions The accuracy of syphilis test results is affected by personnel operation, equipment and facilities, reagent, standard treatment,related diseases and other factors, so targeted prevention programs should be designed to improve the accuracy of the test results.