2016—2022年广州地区献血者梅毒筛查及归队回顾性分析

Serological screening and retrospective analysis of syphilis among blood donors in Guangzhou from 2016 to 2022

目的了解广州地区献血者梅毒螺旋体抗体筛查及其结果呈单试剂反应性献血者归队情况,为制定相应人群招募与归队策略提供依据。方法采用梅毒螺旋体抗体酶联免疫吸附法试剂盒(抗-TP-ELISA)对2016—2022年广州地区无偿献血者进行双试剂血液筛查;统计分析单、双试剂呈反应性构成比以及单试剂梅毒抗体呈反应性献血者归队资料;随机选择2022年部分抗-TP-ELISA呈反应性标本作梅毒螺旋体明胶颗粒凝集试验(TPPA)确认。结果2016—2022年广州地区共筛查无偿献血者1842945份,抗-TP-ELISA呈反应性共5029份(0.27%),双试剂呈反应性3804份(0.21%),单试剂呈反应性1195份(0.06%),逐年呈递减趋势(P<0.05);单试剂呈反应性1195份标本中,“首次献血者”共236份(19.7%),复查合格归队后再次献血的102份(8.5%),占“首次献血者”的43.2%(102/236)。“固定献血者”共231份,其中复查归队并再次献血的64份(64/1195,5.4%),占“固定献血者”的27.7%(64/231);抗-TP-ELISA呈反应性标本186份进行TPPA的确证阳性率为91.9%(171/186),其中172份A、B双试剂均呈反应性标本中TPPA确证阳性的有168份(97.7%,168/172),单试剂呈反应性标本共14份中有3例为TPPA阳性,单双试剂TPPA阳性率比较差异有统计学意义(P<0.05)。结论2016—2022年广州地区无偿献血者筛查中TP抗体阳性率呈逐年下降趋势;采供血机构应关注抗-TP-ELISA单试剂呈反应性献血者归队的问题,为献血者提供精准服务。

Objective To investigate the screening of treponema pallidum antibody in blood donors in Guangzhou and the return of blood donors who showed single reagent reactivity,to provide the basis for the formulation of corresponding population recruitment and return strategy.Methods Double-reagent blood screening was performed among volunteer blood donors in Guangzhou from 2016 to 2022 using an enzyme-linked immunosorbent assay kit(anti-TP-ELISA)for detecting Treponema pallidum antibodies.The data of blood donors with single-reagent and double-reagent reactivity composition and single-reagent syphilis antibody reactivity were analyzed statistically.Part of the reactive anti-TP-ELISA samples in 2022 were randomly selected for the confirmation of Treponema pallidum gelatin particle agglutination test(TPPA).Results A total of 1842945 unpaid blood donors were screened in Guangzhou from 2016 to 2022,of which 5029(0.27%)were reactive with anti-TP-ELISA and 3804(0.21%)were reactive with double reagents.The reactivity of single-reagent was 1195 cases(0.06%),which showed a decreasing trend year by year(P<0.05).Of the 1195 specimens that showed single-agent reactivity,there were 236 first-time blood donors(19.7%)and 102 blood donors who returned to the team after reexamination(8.5%),accounting for 43.2%of first-time blood donors(102/236).There were 231"fixed blood donors",of which 64(64/1195,5.4%)returned to the team and donated blood again,accounting for 27.7%(64/231)of"fixed blood donors".The positive rate of TPPA in 186 anti-TP-ELISA samples was 91.9%(171/186),of which 172 A and B reagents were both positive and 168(97.7%,168/172)were confirmed positive for TPPA.Among the 14 reactivity samples,3 cases were positive for TPPA.There was a statistical difference in the positive rate of TPPA with single and double reagents(P<0.05).Conclusion The positive rate of TP antibody in the screening of volunteer blood donors in Guangzhou from 2016 to 2022 showed a decreasing trend year by year.Blood collection and supply institutions should pay attention to the return of blood donors who are reactive to anti-TP-ELISA,and provide accurate services for blood donors.