梅毒血清学检测应用在诊断咽喉部病变患者的准确性及价值研究

Study on the accuracy and value of syphilis serology in the diagnosis of patients with throat disease

目的分析梅毒血清学检测诊断咽喉部病变患者的准确性与价值,进而减少疾病漏诊与误诊的发生。方法遴选本院耳鼻喉科首诊且有局部阳性体征的48例患者为探究对象,研究开展至完成时间段为2019年10月-2021年10月,对于咽喉病变临床特点进行分析,应用化学发光免疫分析技术(CLIA)实施梅毒螺旋体(TP)抗体检测,对于阳性标本实施甲苯胺红不加热血清试验(TRUST),对于检测结果进行分析。结果48例患者中,有32例TP抗体阳性,阳性率为66.67%。在32例TP阳性患者中,13例TRUST滴度≥1:8,占比为40.63%。23例经临床询问病史、分析临床症状确定为梅毒感染,其中7例主诉为疑似咽喉痛和声音嘶哑,首诊为咽峡炎、化脓性扁桃体炎,经治疗后效果不佳,病情反复发作。入院后全部患者进行血常规检验,结果显示为TP-CLIA阳性,进一步实施TRUST试验,滴度≥1:8,证实为阳性,剩余2例原因不明。2例患者均有双侧软腭、咽喉部黏膜、扁桃体灰白色假膜,显著高于黏膜表面,擦拭困难,且表面糜烂不光洁。结论较多梅毒患者往往会首诊于咽喉科,主要特点是以咽痛为主诉,咽喉黏膜存在灰白色,极易造成漏诊和误诊,为提高梅毒患者的检出率,临床可进行梅毒血清学检测,可及时明确病变情况,具有较高的诊断准确性,具有理想的临床应用价值。

Objective To analyze the accuracy and value of syphilis serological testing in diagnosing patients with throat disease,so as to reduce the incidence of missed and misdiagnosed diseases.Methods 48 patients with local positive signs who were first diagnosed by the Department of Otolaryngology in this hospital were selected as the subjects of investigation.The period from October 2019 to October 2021 from the beginning of the study to the completion of the study was performed.The clinical characteristics of throat lesions were analyzed and chemiluminescence was used.Microparticle immunoassay technology(CLIA)implements Treponema pallidum(TP)antibody testing,implements toluidine red unheated serum test(TRUST)for positive samples,and analyzes the test results.Results Among the 48 patients,32 were positive for TP antibody,with a positive rate of 66.67%.Among 32 TP-positive patients,13 cases had TRUST titer≥1:8,accounting for 40.63%.23 cases were determined to be syphilis infection through clinical history and analysis of clinical symptoms.Among them,7 cases complained of suspected sore throat and hoarseness.The first diagnosis was angina and suppurative tonsillitis.After treatment,the effect was not good,and the disease recurred.After admission,all patients underwent routine blood tests,the results showed that TP-CLIA was positive,and the TRUST test was further carried out,and the titer was≥1:8,which was confirmed to be positive.The remaining 2 cases were unexplained.Both patients had bilateral soft palate,throat mucosa,and tonsil gray-white pseudomembrane,which was significantly higher than the mucosal surface,which was difficult to wipe,and the surface was not smooth and clean.Conclusion Many patients with syphilis are often first diagnosed in the pharyngology department.The main feature is that the main complaint is sore throat,and the throat mucosa is gray,which can easily lead to missed diagnosis and misdiagnosis.In order to improve the detection rate of syphilis patients,clinical syphilis serology can be performed.Detection can clarify the condition of the disease in time,has high diagnostic accuracy,and has ideal clinical application value.