CAJ | 학술논문

目的探讨采供血机构开展梅毒螺旋体(TP)检测的最佳方案,减少因输血引起的TP传染.方法选择2012年1月至2013年12月,于东营市中心血站无偿献血的50 000例献血者为研究对象.分别采用2个不同生产厂家的TP-酶联免疫吸附试验(ELISA)试剂盒以及TP-甲苯胺红不加热血清试验(TRUST)试剂盒检测献血者TP.对TRUST检测结果呈阳性,而TP-ELISA结果呈阴性的献血者,于献血后3个月,再次进行2次TP-ELISA检测和1次TRUST检测.以2次TP-ELISA检测或TP-ELISA和TRUST二者检测结果均呈阳性的血液样本,确认为TP血清学结果呈阳性.对2011-2013年因TP检测结果呈阳性而被淘汰的献血3次以上献血者随访3个月,调查其是否在不洁的性行为后参加献血.结果本组50 000例献血者中,共检出TP检测结果呈阳性为171例,其中TP-ELISA检测结果呈阳性为163例,TRUST检测结果呈阳性为167例,2种方法检测结果均呈阳性为159例.在171例TP检测结果呈阳性的献血者中,TP-ELISA检测结果呈阴性,而TRUST呈阳性的献血者为8例,占4.6％ (8/171);TRUST呈阴性,而TP-ELISA呈阳性为4例,占2.3％(4/171).两种方法的血清学检测阳性率比较,差异有统计学意义(x2=134.42,P＜0.05).8例经TRUST检测TP呈阳性献血者献血3个月后复检结果为:仅2例TP-ELISA和TRUST检测结果均呈阳性,初、复检血清学检测结果比较,差异有统计学意义(x2=5.25,P＜0.05).献血3次以上且因TP感染而被淘汰的献血者为11例,其中在最后1次献血前有不洁性行为者为5例,占45.5％(5/11).结论血站开展TP检测的最佳方案应为1次TP-ELISA检测和1次TP非特异性抗体检测,大部分血站(血液中心)现行2次TP-ELISA检测方案值得商榷;固定献血者献血后出现血清学阳性应予以追踪调查.
목적 탐토채공혈궤구개전매독라선체(TP)검측적최가방안,감소인수혈인기적TP전염.방법 선택2012년1월지2013년12월,우동영시중심혈참무상헌혈적50 000례헌혈자위연구대상.분별채용2개불동생산엄가적TP-매련면역흡부시험(ELISA)시제합이급TP-갑분알홍불가열혈청시험(TRUST)시제합검측헌혈자TP.대TRUST검측결과정양성,이TP-ELISA결과정음성적헌혈자,우헌혈후3개월,재차진행2차TP-ELISA검측화1차TRUST검측.이2차TP-ELISA검측혹TP-ELISA화TRUST이자검측결과균정양성적혈액양본,학인위TP혈청학결과정양성.대2011-2013년인TP검측결과정양성이피도태적헌혈3차이상헌혈자수방3개월,조사기시부재불길적성행위후삼가헌혈.결과 본조50 000례헌혈자중,공검출TP검측결과정양성위171례,기중TP-ELISA검측결과정양성위163례,TRUST검측결과정양성위167례,2충방법검측결과균정양성위159례.재171례TP검측결과정양성적헌혈자중,TP-ELISA검측결과정음성,이TRUST정양성적헌혈자위8례,점4.6％ (8/171);TRUST정음성,이TP-ELISA정양성위4례,점2.3％(4/171).량충방법적혈청학검측양성솔비교,차이유통계학의의(x2=134.42,P＜0.05).8례경TRUST검측TP정양성헌혈자헌혈3개월후복검결과위:부2례TP-ELISA화TRUST검측결과균정양성,초、복검혈청학검측결과비교,차이유통계학의의(x2=5.25,P＜0.05).헌혈3차이상차인TP감염이피도태적헌혈자위11례,기중재최후1차헌혈전유불길성행위자위5례,점45.5％(5/11).결론 혈참개전TP검측적최가방안응위1차TP-ELISA검측화1차TP비특이성항체검측,대부분혈참(혈액중심)현행2차TP-ELISA검측방안치득상각;고정헌혈자헌혈후출현혈청학양성응여이추종조사.
Objective To explore the optimal scheme of treponema pallidum (TP) detection in blood services,to reduce the TP infection caused by blood transfusion.Methods From January 2012 to December 2013,a total of 50 000 blood donors in Dongying Central Blood Station were included in this study.Two kinds of TP-enzyme-linked immunosorbent assay (ELISA) kit from different manufacturers and toluidine red unheated serum test (TRUST) kit were used to detect these donors'TP,respectively.The donors whose TP-ELISA detection results were negative,but TRUST detection results were positive,were required to be retested TP by twice ELISA test and once TRUST test,3 months after blood donation.Blood samples were confirmed as serology positive by twice ELISA detection positive or both ELISA and TRUST detection positive.In the period 2011 to 2013,the donors who donated blood more than three times,and were eliminated because of TP positive,were followed-up investigation at least 3 months.These donors were investigated whether to participate in blood donation after dirty sex.Results In 50 000 blood donors,a total of 171 cases were TP positive,including 163 cases of TP-ELISA positive,167 cases of TRUST positive,and 159 cases were both positive.In TP positive results,8 cases were negative of TP-ELISA test results,but positive of TRUST test results,accounting for 4.6％ (8/171).4 cases were TRUST negative,but TP-ELISA positive,accounting for 2.3％ (4/171).There was statistical difference in TP detection results between TP-ELISA and TRUST test (x2=134.42,P＜0.05).Only 2 cases were both TP-ELISA and TRUST positive in 8 donors who were TRUST positive.The difference of serology results was statistically significant between initial inspection and re-inspection (x2 =5.25,P＜0.05).In the follow-up of 11 cases of blood donors,five cases admitted they had unclean sexual history before the blood donation,accounting for 45.5％ (5/11).Conclusions The best scheme of TP detection should be once TP-ELISA detection and once TP nonspecific antibody detection.Twice TP-ELISA detection is questionable in most blood stations (blood center) currently.Fixed blood donors who were TP serological positive after blood donation should be tracked.