五种梅毒血清学试验方法在梅毒临床分期中的应用分析

The application analysis of five syphilis serological tests in clinical stages

目的探讨五种梅毒血清学试验方法在梅毒临床分期中的临床应用价值。方法选取河南省疾病预防控制中心门诊部性病门诊2019年1月至2020年1月确诊的124例梅毒患者血样为研究对象,收集同期130例非梅毒患者血样作为对照组,分别采用ELISA、金标法、TPPA、RPR、TRUST方法进行梅毒血清学检测。结果ELISA、TPPA、胶体金三种方法的敏感度、特异度均显著高于RPR、TRUST,差异有统计学意义(P<0.05)。在Ⅱ期梅毒时,五种检测方法的阳性检出率无统计学差异(P>0.05)。在早期梅毒、Ⅰ期梅毒、Ⅲ期梅毒时,ELISA、TPPA、胶体金三种检测方法与RPR、TRUST阳性检出率有统计学差异(P<0.05)。结论ELISA用于大批量样本检测,金标法用于急诊、术前及简易门诊的就诊者检测,TPPA用于梅毒确诊实验。TRUST或RPR可用于判断梅毒患者的严重程度、疗效判断及梅毒复发。五种方法可根据临床工作需要进行联合检测,提高临床诊断的准确性。

Objective To explore the clinical application value of five serological tests for syphilis.Methods 124 cases of syphilis patients and 130 non-syphilis patients of outpatient department in Henan Center For Disease Control and Prevention from Jan.2019 to Jan.2020 were selected.Enzyme-linked immunosorbent assay(ELISA),gold immunochromatography(GICA),treponema pallidum particle agglutination test(TPPA),rapid plasma reagin circle card test(RPR)and tolulized red unheated serum test(TRUST)were performed to detect the syphilis.Results The sensitivity and specificity of ELISA,GICA and TPPA were higher than TRUST and RPR,P<0.05.In the case ofⅡstage syphilis,there was no statistical difference in the positive detection rate of the five test methods(P>0.05).In the early stage,ⅠandⅢstage of syphilis,there was significant difference in positive detection rates between ELISA,TPPA,GICA and other methods.Conclusion ELISA was suitable for large-scale test.GICA was used for the test of emergency,preoperative and simple outpatient visits.TPPA was used for syphilis confirmation.TRUST or RPR can be used to determine the severity,efficacy and recurrence of syphilis.The five methods can be to improve the accuracy of clinical diagnosis.