全自动化学发光仪筛查梅毒螺旋体抗体结果分析

摘要

Objective To comprehensively analyze the examination results of treponema pallidum antibody detected by full-automatic chemiluminescence apparatus (A2000).Methods A total of 10,715 patients who were hospitalized and routinely examined before blood transfusion and before surgery in our hospital were enrolled in the study,the serum levels of treponema pallidum antibody were detected by chemiluminescent immunoassay (CLIA).Results The positive rate of treponema pallidum antibody was the highest in department of dermatology (52 cases),accounting for 0.49％ of the total specimens,no false positive specimen was found.The positive rate of treponema pallidum antibody was increased in department of obstetrics and gynecology,which was second only to department of dermatology.In department of gynaecology and obstetrics,there were 24 cases of preliminary screening positive,6 cases of false positive.In dpsrtment of internal medicine,there were 15 cases of positive and 2 cases of false positive,moreover,there were 13 cases of positive and 3 cases of false positive in department of surgery.In addition there were 13 cases of preliminary screening positive,without false positive specimen in department of ophthalmology and otorhinolaryngology,and there was 1 case of preliminary screening positive,1 case of false positive in department of osteology.Besides there were 2 cases of preliminary screening positive,without false positive specimen in ICU,however,the positive rate of treponema pallidum antibody was 0 in department of pediatrics.Among 10715 specimens,there was no false negative specimen,there were 12 cases of false positive specimens,which were all weakly positive,with S/Co value being 1 ～ 3.32,and total false positive rate was 0.11％.Conclusion The application of full-automatic chemiluminescence detector (A2000) by means of CLIA in a great number of preliminary screening detection of syphilis has advantages of quick detection and high sensitivity,which can meet the clinical needs,however,because of its high sensitivity,the positive results should not be regarded as the only basis for clinical diagnosis and treatment,it should be combined with the patient's symptoms,medical history,other laboratory methodology examination,the patient's response to treatment and epidemiological information to evaluate the detection results.%目的 对全自动化学发光仪(A2000)筛检梅毒螺旋体抗体的结果进行综合分析.方法 选取住院的输血前和手术前常规检查患者及门诊就诊患者10 715例,应用磁微粒化学发光法(CLIA)检测血清中梅毒螺旋体抗体.结果 梅毒螺旋体抗体阳性标本以皮肤性病科(52例)最多,占总检测人数的0.49％,无假阳性现象;妇产科梅毒螺旋体抗体阳性标本增高,仅次于皮肤性病科,妇产科初筛阳性24例,假阳性6例;整个内科梅毒螺旋体抗体阳性15例,假阳性2例;整个外科梅毒螺旋体抗体阳性13例,假阳性3例;五官科初筛阳性9例,无假阳性;骨科初筛阳性1例,假阳性1例;重症医学科初筛阳性2例,无假阳性;儿科梅毒螺旋体抗体阳性率为0.10 715例血标本总共假阴性0例,假阳性12例,结果均为弱阳性,S/CO值介于1～3.32,总假阳性率0.11％.结论 全自动化学发光仪(A2000)应用CLIA法对于梅毒的大批量初筛检测,快速且灵敏度高,可满足临床需要,但正因为它的高灵敏性,所测得的阳性结果,不应作为临床诊治的唯一依据,应结合患者的体征、病史、其他的实验室方法学检查、患者的治疗反应及流行病学等信息进行综合考虑.尤其要重视筛检S/CO值介于1～3.32的弱阳性结果,工作中要注意血样本离心要充分,避免技术性假阳性.对于筛检阳性结果要及时通知临床并进行沟通,建议确证,避免因假阳性情况误导临床治疗.