快速血浆反应素试验在妊娠和非妊娠妇女梅毒筛查中的性能比较

摘要

目的 研究快速血浆反应素试验(RPR)在妊娠和非妊娠妇女梅毒检测中的性能,为妊娠妇女梅毒检测提供参考.方法 选择年龄为20~40岁的妇女,分为妊娠组和非妊娠组,同时采用RPR和梅毒螺旋体明胶颗粒凝集试验(TPPA)进行梅毒检测.以TPPA检测结果结合患者接触史、临床症状、治疗情况判定阳性病例,与RPR检测的结果比较,确定RPR法的假阴性和假阳性;分析2组RPR检测结果的假阳性率和假阴性率.结果 在妊娠组117例妇女中,RPR假阴性15例、假阳性9例;在非妊娠组755例妇女中,RPR假阴性44例、假阳性8例.妊娠组、非妊娠组假阴性率分别为25.0%、8.8%,其差异有统计学意义(χ2=14.739,P<0.05);妊娠组、非妊娠组假阳性率分别为15.7%、3.1%,其差异有统计学意义(χ2=14.722,P<0.05).结论 影响RPR检测梅毒的因素较多,妊娠妇女为特殊人群,比非妊娠妇女存在更高的假阳性和假阴性率,宜结合患者的临床症状和病史综合判定结果,必要时联合其他梅毒检测方法,避免漏诊和误诊.%Objective To study comparatively the performance of rapid plasma reagin (RPR) test in syphilis detection among pregnant women and non-pregnant women to provide reference for detecting syphilis in pregnant women.Methods The women aged 20-40 years old were selected and divided into the pregnant group and the non-pregnant group.RPR and treponema pallidum particle assay(TPPA) were simultaneously adopted to conduct the syphilis detection.The positive cases were judged by the TPPA detection results combined with the contact history,clinical symptoms and treatment situation.The results were compared with those by RPR for determining the false negative and false positive in RPR.The false negative rate and false positive rate of RPR detection results were analyzed in the two groups.Results Among 117 pregnant women,15 cases were false negative in RPR and 9 cases were false positive in RPR;among 755 non-pregnant women,there were 44 cases of false negative RPR results and 8 cases of false positive RPR results.The false negative rates in the pregnant group and non-pregnant group were 25.0% and 8.8% respectively,the difference was statistically significant(χ2=14.739,P<0.05);the false positive rates in the pregnant group and non-pregnant group were 15.7% and 3.1% respectively,the difference was statistically significant (χ2=14.722,P<0.05).Conclusion There are many factors affecting RPR for detection syphilis,pregnant women are the specific group,so higher false positive rate and false negative rate exist than non-pregnant women,the detection results should be comprehensively judged by combining with clinical symptoms and disease history,if necessary,combining with other syphilis detection method for avoiding missed diagnosis and misdiagnosis.