人免疫球蛋白对血液病患者梅毒螺旋体抗体检测的影响

摘要

Objective To Analyze the change of Syphilis antibodies in patients with hematopathy before or after use of human Immunoglobulintreatment,and provide a reference for clinical diagnosis.Method Fifty-two cases of Syphilis antibody absorbance signal of sample cutoff value (S/CO) ＞0.5 in patients with hematological diseases were detected by chemiluminescence immunoassay (CLIA),42 of them were injected with human immunoglobulin.Two ELISA reagents were used for verication.Syphilis haemagglutination assay (TPHA) was performed for confirmation.Nine cases were followed up for detection of Syphilis antibody after withdraw of human Immunoglobulin administration.To compare the results of human Immunoglobulin in vivo and in vitro,times dilution the Harbin Paisi ficco Human Immunoglobulin with saline and AB type plasma to detect Syphilis antibody,simultaneous test the results of Chengdu rongsen Human Immunoglobulin (PH4).Result 10 patients showed positive TPHA,42 patients who had received human Immunoglobulin injection presented positive rates of 78.6％,88.1％ and 66.7％ in Syphilis antibody detection when tested by different reagents purchased from Johnson,Wan Tai and Sorin,TPHA,however,was found to be negative in all patients.Nine patients revealed positive Syphilis antibody after withdraw of human Immunoglobulin.Conclusion Human Immunoglobulin administration may cause a false positive detection of Syphilis antibody in patients with hematological diseases.The patients with the experience of human Immunoglobulin treatment together with low Syphilis antibody reaction should be re-checked for Syphilis antibody after three months.%目的 分析血液病患者静注人免疫球蛋白前后梅毒螺旋体抗体检测结果的变化,为临床检验诊断提供参考.方法 采用化学发光法(CLIA)试剂检测人免疫球蛋白血液病患者梅毒螺旋体抗体S/CO＞0.5标本52例,其中42例输注入免疫球蛋白,采用两种酶联免疫法(ELISA)试剂复查,梅毒螺旋体血凝实验(TPHA)进行确认.追踪9例血液病患者停止输注人免疫球蛋白后梅毒螺旋体抗体检测结果的变化.为将人免疫球蛋白(PH4)用生理盐水和AB型血浆倍比稀释,检测梅毒螺旋体抗体,比较体内外人免疫球蛋白检测结果.结果 10例患者经TPHA确证为阳性.42例输注人免疫球蛋白的血液病患者梅毒螺旋体抗体经强生、万泰和索林试剂检测,阳性率分别为78.6％、88.1％和66.7％,TPHA确认均为阴性.9例患者停止输注人免疫球蛋白一段时间后,梅毒螺旋体抗体检测结果转为阴性.人免疫球蛋白用生理盐水和AB型血浆稀释前、后经3种试剂检测均有不同程度的阳性.结论 人免疫球蛋白会引起血液病患者梅毒螺旋体抗体检测呈假阳性,有人免疫球蛋白输注史且梅毒螺旋体抗体检测阳性反应低的患者,建议停止输注3个月后复查梅毒螺旋体抗体.