基础医学与临床 ›› 2020, Vol. 40 ›› Issue (10): 1381-1384.

• 研究论文 • 上一篇    下一篇

CMIA方法筛查儿童抗梅毒特异性抗体结果的解读

宋秦伟, 王娅琳, 刘智圆, 张易, 高爽, 马丽娟*   

  1. 首都儿科研究所附属儿童医院 检验科, 北京 100020
  • 收稿日期:2020-07-01 修回日期:2020-08-16 出版日期:2020-10-05 发布日期:2020-09-29
  • 通讯作者: * lijuanmary@sina.com
  • 基金资助:
    北京市医院管理局“青苗”计划专项基金(QML20171304)

Interpretation of CMIA test results of syphilis antibody in children

SONG Qin-wei, WANG Ya-lin, LIU Zhi-yuan, ZHANG Yi, GAO Shuang, MA Li-juan*   

  1. Department of Clinical Laboratory, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
  • Received:2020-07-01 Revised:2020-08-16 Online:2020-10-05 Published:2020-09-29
  • Contact: * lijuanmary@sina.com

摘要: 目的 探究如何正确解读化学发光微粒子免疫分析法(CMIA)筛查检测儿童抗梅毒螺旋体特异性抗体阳性(S/CO>1)结果。方法 收集2018年7月至2019年6月用CMIA方法从 23 038例患儿中筛查到的抗梅毒螺旋体(TP)特异性抗体阳性的(S/CO>1)临床血清样本,再采用梅毒螺旋体明胶凝集试验(TPPA)复检;甲苯胺红不加热血清学试验(TRUST)检测TP非特异性抗体;免疫印迹法(Western blot)检测TP特异性IgG和IgM抗体。结果 CMIA初筛阳性(S/CO>1)141例,初筛阳性率为0.61%(141/23 038)。141例CMIA阳性患儿血清复检结果:TRUST阳性2例(1.42%,2/141),TPPA阳性7例(4.96%,7/141),IgG阳性13例(9.22%,13/141),IgM阳性6例(4.25%,6/141);其中S/CO >10者11例,包括TRUST阳性2例(18.18%,2/11),TPPA阳性7例(63.64%,7/11),IgG阳性10例(90.91%,10/11),IgM阳性3例(27.27%,3/11)。10例父母或母亲有梅毒病史(90.91%,10/11),年龄小于6个月者9例(81.82%,9/11)。结论 用CMIA方法对儿童进行梅毒螺旋体的筛查,当其S/CO<10时,假阳性率仍然较高,需要用确证方法进行排除;梅毒检测结果需要结合患儿年龄及其父母的梅毒病史进行正确解读。

关键词: 化学发光微粒子免疫分析法, 梅毒螺旋体抗体, 儿童, 假阳性

Abstract: Objective To explore how to correctly interpret the results of CMIA screening for anti-treponema pallidum specific antibody(S/CO > 1) in children. Methods From July 2018 to June 2019, 23 038 patients had been screened for anti-TP antibody by CMIA, the positive results(S/CO > 1) were re-examined by Treponema pallidum particle agglutination assay(TPPA), TP nonspecific antibody was checked by tolulized red unheated serum test(TRUST) and TP specific IgG and IgM antibody were confirmed by Western blot. Results Totally 23 038 patients were screened for anti-TP antibody by CMIA, among them 141 were positive(S/CO>1) with and the positive rate as 0.61%(141/23 038). The re-test results of 141 children(S/CO>1) were as follows: the number of positive cases of TRUST, TPPA, IgG and IgM were 2(1.42%, 2/141), 7(4.96%, 7/141), 13(9.22%, 13/141) and 6(4.25%, 6/141), respectively. In addition, 11 cases with S/CO>10, including the number of positive cases of TRUST, TPPA, IgG and IgM were 2(18.18%, 2/11),7(63.64%,7/11), 10(90.91%, 10/11) and 3(27.27%, 3/11) , respectively, 10(90.91%, 10/11) cases of parents had syphilis history and 9(81.82%, 9/11) cases were younger than 6 months. Conclusions Screening the children with Treponema pallidum by CMIA, when the S/CO<10, the false-positive rate was high when the S/CO<10, which must be excluded by confirmatory methods. The correct interpretation of syphilis test results should combine with the age of the child and the history of syphilis of his or her parents.

Key words: chemiluminescent microparticle immunoassay, antibodies to treponema pallidum, children, false positive

中图分类号: