373例普通住院患者梅毒酶免疫法筛查阳性结果分析

目的探讨普通住院患者梅毒酶联免疫吸附试验（ELISA）筛查阳性病例在不同年龄组和临床科室的分布情况，分析ELISA法梅毒抗体检测的应用价值。方法用ELISA法对普通住院患者进行梅毒抗体初筛，阳性者进一步做梅毒螺旋体明胶颗粒凝集试验（TPPA）和梅毒甲苯胺红不加热血清试验（TRUST）。结果28970例临床标本ELISA法筛查阳性373例（1．29％），与TPPA符合率为97．86％；其中328例TRUST滴度小于或等于1：2，占ELISA法的87．94％。20岁以下患者ELISA法阳性率为0．47％（6／1282），20～50岁以下和50～70岁以下年龄组阳性率分别为1．19％（206／17372）和1．01％（93／9240），而70岁以上老年人阳性检出率高达6．32％（68／1076）。几乎全部临床科室均有梅毒筛查阳性病例，其中妇产科、肿瘤科、血液科、眼科和泌尿外科的阳性率分别为2．75％、2．51％、1．71％、2．05％和1．57％，显著高于普通住院患者平均阳性水平。结论ELISA法是较好的梅毒筛查试验。大部分筛查阳性病例并非梅毒现症感染患者，主要分布在妇产、肿瘤、泌尿等临床科室，并且妇科肿瘤和其他恶性肿瘤及老年性疾病患者可能为生物学假阳性。

Analysis of TP-ELISA screening positive results in 373 cases of common inpatients

Objective To explore the distribution of treponema pallidum screening positive cases with ELISA method among various age groups and different clinical departments, and to analyze the applicable value of syphilis serological detection with ELISA. Methods The clinical specimens from common inpatients underwent routine treponema pallidum antibody screening with ELISA method. All screening positive samples were further tested by treponema pallidum particle assay（TPPA） and tolulized red unheated serum test（TRUST）. Results 373 positive clinical specimens（1.29%） were detected by TP-ELISA out of a total of 28 970 specimens, and the coincidence rate was 97.86% with TPPA,in which 328 cases（87.94 %） were with TRUST titre equal or below 1 ： 2. In addition, the positive rate of 20 years younger group,20-50 years group,50-70 years group and 70 years older group was 0.47% （6/1 282）,1.19%（206/17 372） ,1.01%（93/9 240） and 6.32%（68/1 076） ,respectively. The TP screening positive cases distributed over all clinical departments. The positive rate of Department of Obstetrics and Gynecology, Department of Oncology,Department of H aematology, Department of Ophthalmology, and Department of Urology was 2.75 %, 2.51% ,1.71% ,2.05% and 1. 57% respectively,much higher than that of common inpatients. Conclusion ELISA method is preferable for screening serum anti-TP antibody. Most positive cases arentt TP current infection patients. These cases mostly distribute over the clinical departments（e, g. Department of Obstetrics and Gynecology, Department of Oncology,and Department of Urology）. Moreover, the positive cases of gynecologic tumor, the other malignant tumor patients and senile disease patients are likely to be biological false positive.