3种方法联合检测在老年梅毒诊断中的应用价值

Applicable value of combined detection of three methods in diagnosis of senile syphilis

目的探讨酶联免疫吸附试验(ELISA)梅毒筛查联合梅毒甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体明胶凝集试验(TPPA)在老年梅毒检测中的应用价值。方法用ELISA法作为临床标本的梅毒筛查,对筛查阳性标本进一步作TRUST和TPPA检测。结果ELISA法检出78例梅毒阳性标本,TPPA确证阳性53例,阳性符合率为67.95%(53/78);其中51例TRUST阳性,且TPPA确证试验均为阳性;27例TRUST阴性,TPPA确证25例阳性,2例为阴性。结论ELISA法筛查梅毒在老年梅毒检测中存在着较高比例的假阳性结果,ELISA阳性标本首先应做TRUST,而对TRUST阴性标本应进一步用TPPA确证,以减少梅毒的误诊和医疗纠纷。

Objective To explore the applicable value of combined detection of three methods [enzyme linked immunosorbent assay （ELISA）, syphilis toluidine red untreated serum test （TRUST） and treponemapallidum particle agglutination assay （TPPA）] in diagnosis of senile syphilis. Methods The clinical specimens underwent routine treponema pallidum antibody screening with ELISA method. All ELISA positive samples were further confirmed by TRUST and TPPA. Results Among 78 treponema pallidum antibody screening positive specimens, 53 samples were confirmed positive by TPPA, and the positive coincidence rate of ELISA and TPPA was 67.95%; in which 51 cases were both TRUST and TPPA. A total of 27 cases were TRUST negative and TPPA positive. In 27 cases with TRUST negative results, 25 cases were TPPA positive and 2 cases were TPPA negative. Conclusion High rate of ELISA false positive result existed in senile syphilis screening test. ELISA screening positive specimens should be firstly detected with TRUST. All TRUST negative samples by ELISA should be further tested by TPPA so as to reduce the misdiagnosis and medical dispute in diagnosis of senile syphilis.