摘要
目的:探讨以化学发光免疫试验(CLIA)替代RPR作为指标指导治疗中给药、停药、评判疗效及确认血清固定的可行性。方法:收集我院2018年4月-2019年4月就诊的375例梅毒患者结果,将其RPR滴度和CLIA检测值进行spearman相关性分析;以RPR滴度分组,将CLIA检测值进行秩和检验;以不同的RPR滴度为状态变量,分别进行ROC曲线分析及约登指数计算,找出每一RPR滴度对应的CLIA临界值;以RPR滴度为横坐标,CLIA检测值作纵坐标,绘制散点图并进行曲线拟合。结果:CLIA检测值与RPR滴度呈正相关, CLIA在不同RPR滴度分组中分布不完全相同。RPR滴度从低到高对应不同的CLIA临界值。拟合最优曲线为三次曲线,R^2=0.695,F=281.805,P<0.01。结论:CLIA检测值与RPR滴度的对应关系为三次方曲线,CLIA检测值总体随RPR滴度增高有升高趋势,但在某些滴度有部分倒错。CLIA检测值高于13.655可直接作为梅毒患者确诊指标,不需其他方法佐证。高于13.655可确定给药,低于13.655可考虑停药。治疗后CLIA值介于13.655和15.320之间的病例可认定为血清固定, CLIA方法可用于判断滴度较低的病例及血清固定病例,以CLIA检测值完全取代RPR滴度进行疗效观察尚需更多依据。
Objective:To investigate the feasibility of replacing RPR with chemiluminescence as a scale of administration, drug withdrawal,evaluation of efficacy and serum fixation.Methods:The results of 375 patients with syphilis from April 2018 to April 2019 in our hospital were collected.Spearman correlation analysis was performed between RPR titer and CLIA index.The rank sum test of CLIA detection index grouping by RPR titers was performed. With different RPR titers as state variables,ROC curve analysis and Jordan index calculation were performed to find the CLIA critical index corresponding to each RPR titer;RPR titer was used as the abscissa and CLIA detection index was used as the ordinate.Draw a scatter plot and perform a curve fit.Results:The CLIA test index was positively correlated with the RPR titer.The CLIA distribution ware not exactly same in different RPR titer groups.RPR titers from low to high correspond to different CLIA thresholds.The fitting optimal curve is cubic curve,R^2=0.695,F=281.805,P<0.01.Conclusion:The correspondence between CLIA detection index and RPR titer is a cubic curve,The CLIA detection index generally increase with the increase of RPR titer,but there is a partial inversion in some titer.The CLIA detection index which higher than 13.655 can be directly used as the diagnostic indicator for syphilis patients.There’s no need to do other detection to confirm it.Administration was determined when CLIA detection index higher than 13.655.After treatment discontinuation of drug should be considered when CLIA index below 13.655.The CLIA index between 13.655 and 15.320 can be identified as serum fixation after regular treatment.CLIA can be used to determine cases with low titers and serum-fixed cases.More evidences were needed for the efficacy of CLIA detection to completely replace RPR titers in treatment.
作者
滕颖
TENG Ying(Laboratory of the Second People’s Hospital of Tianjin,300192)
出处
《医学理论与实践》
2020年第8期1223-1226,共4页
The Journal of Medical Theory and Practice
