梅毒患者血清学生物假阳性的影响因素分析

Analysis of the influencing factors of serological false positive in patients with syphilis

目的分析梅毒患者血清学生物假阳性的影响因素。方法选取2017年9月至2019年5月该院收治的疑似梅毒患者538例作为研究对象,空腹抽取静脉血2 mL,经离心获取血清后行甲苯胺红不加热血清试验(TRUST)检测。收集患者的年龄、性别、基础疾病(恶性肿瘤、风湿免疫系统疾病、心血管疾病、脑部疾病、内分泌疾病、感染性疾病、泌尿系统疾病、呼吸系统疾病、血液系统疾病、消化系统疾病、骨科疾病、营养代谢疾病、妊娠)、输血史,采用logistic回归分析梅毒患者血清学生物假阳性的影响因素。结果290例(53.90%)患者为血清学生物假阳性,经单因素分析,性别、心血管疾病、脑部疾病、内分泌疾病、泌尿系统疾病、呼吸系统疾病、血液系统疾病、消化系统疾病、骨科疾病、营养代谢疾病、妊娠、输血史不是梅毒患者血清学生物假阳性的影响因素(P>0.05),年龄、恶性肿瘤、风湿免疫系统疾病、感染性疾病为梅毒患者血清学生物假阳性的影响因素(P<0.05)。多因素logistic回归分析显示,年龄≥60岁,患有恶性肿瘤、风湿免疫系统疾病、感染性疾病为梅毒患者血清学生物假阳性的独立影响因素(P<0.05)。结论年龄≥60岁的老年人,患有恶性肿瘤、风湿免疫系统疾病、感染性疾病是TRUST检测梅毒患者血清学生物假阳性发生的危险因素,临床上需注意年龄偏大、患有基础疾病导致的梅毒血清学生物假阳性,向患者做出合理解释。

Objective To analyze the influencing factors of serological false positive in patients with syphilis.Methods A total of 538 suspected syphilis patients admitted to the hospital from September 2017 to May 2019 were selected as research objects.2 mL of venous blood was extracted on a fasting stomach and tested by toluidine red unheated serum test(TRUST)after serum was obtained by centrifugation.The patient′s age,sex,basic diseases(malignant tumor,rheumatoid immune system disease,cardiovascular disease,brain disease,endocrine disease,infectious diseases,urinary system diseases,respiratory diseases,diseases of the blood system,digestive system disease,bone disease,nutritional metabolic disease,pregnancy)and history of blood transfusion were collected.The influencing factors of serological false positive in patients with syphilis were analyzed byχ2 test and binary logistic regression.Results A total of 290(53.90%)patients were serological false positive.The univariate analysis showed that gender,cardiovascular disease,brain disease,endocrine disease,urinary system disease,respiratory disease,blood system disease,digestive system disease,orthopedic disease,nutritional metabolic disease,pregnancy,blood transfusion history is not the impact factors of serological false positive in patients with syphilis(P>0.05),while age,malignant tumor,rheumatic immune system disease and infectious disease were the factors affecting the serological false positive in patients with syphilis(P<0.05).Multivariate binary logistic regression analysis showed that over 60 years old(including 60 years old),with malignant tumor,rheumatic immune system disease,infectious disease were independent influencing factor of serological false positive in patients with syphilis(P<0.05).Conclusion Over 60 years old(including 60 years old),with malignant tumors,rheumatic immune system diseases and infectious diseases are the risk factors for TRUST testing serological false positive in patients with syphilis.Attention should be paid to serological false positive of syphilis patients with older age and basic diseases,and reasonable explanations should be made to them.