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目的评价使用化学发光法(CLIA)检测梅毒特异性抗体进行逆向产前梅毒筛查的流程,为制定合适的产前梅毒筛查流程提供依据。方法回顾性分析逆向产前梅毒筛查流程的实验室数据,以CLIA作为梅毒螺旋体特异性抗体筛查试验,初筛阳性标本同时进行非梅毒螺旋体抗原血清甲苯胺红不加热试验(TRUST)检测和梅毒螺旋体明胶颗粒凝集试验(TPPA)复测,TRUST阳性标本同时进行滴度测定。结果在8 998份产前筛查标本中CLIA筛查阳性标本为122份,筛查阳性率为1.36%;122份阳性标本中TRUST阳性为42份,与CLIA阳性符合率为34.43%,TPPA阳性为114份,与CLIA阳性符合率为93.44%,TRUST与TPPA阳性率差异有统计学意义(P<0.01),42份TRUST复测阳性标本中有41份TPPA复测阳性,TRUST滴度检测结果分布在1∶1~1∶64,高滴度标本患者临床诊断主要为二期梅毒。结论使用CLIA检测梅毒特异性抗体进行逆向产前梅毒筛查,阳性再做TRUST及滴度检测,两者不符使用TPPA进行确认的流程是可行的,提高了敏感性,降低了假阴性,优于目前使用的传统产前梅毒筛查模式。
Objective To evaluate the procedure of inverse prenatal syphilis screening by chemiluminescence (CLIA) for the detection of syphilis-specific antibodies and provide a basis for the development of suitable prenatal syphilis screening procedures. Methods The laboratory data of reverse prenatal syphilis screening procedure were retrospectively analyzed. CLIA was used as the screening test for Treponema pallidum specific antibody, and the positive samples were also screened for the detection of non-Treponema pallidum serine toluidine red non-heating test (TRUST) Treponema pallidum gelatin particle agglutination test (TPPA) retest, TRUST positive samples simultaneously titer determination. Results The positive screening rate of CLIA was 122 in 8 998 samples of prenatal screening, and the positive rate of screening was 1.36%. Among 122 positive samples, 42 were TRUST positive, 34.43% positive with CLIA, and positive for TPPA (114.44%). The coincidence rate of TRUST and TPPA was 93.44%, and the positive rate of TRUST and TPPA was statistically significant (P <0.01). The positive rate of TRPA titration was 41 in 42 TRUST positive samples Distribution in the 1: 1 ~ 1:64, high titer specimens of patients with clinical diagnosis of secondary syphilis. Conclusion It is feasible to use CLIA to detect syphilis-specific antibodies for reverse prenatal screening of syphilis, TRUST-positive, and titered tests, which is inconsistent with the procedure of TPPA for confirmation, which increases the sensitivity and reduces false negatives and is superior to Traditional prenatal syphilis screening patterns currently in use.