TPPA和TRUST两种检查方法在梅毒血清学检查中的应用

TPPA and TRUST Two Methods in Syphilis Serology Application

目的探讨分别采用明胶颗粒凝集试验(TPPA)和甲苯胺红不加热血清试验(TRUST)两种检查方法在梅毒血清学检查中的应用。方法选择我院2005年1月—2009年12月26例梅毒血清标本作为研究对象,根据梅毒的诊断标准[2]:其中Ⅰ期梅毒10例,Ⅱ期梅毒9例,Ⅲ期梅毒4例,潜伏梅毒3例;另选10例经临床确定为类风湿性关节炎、乙型肝炎、SLE、肺结核的作为对照组;以及10例健康体检者作为研究对象。46例标本采用明胶颗粒凝集试验(TPPA)和甲苯胺红不加热血清试验(TRUST)两种检查方法同时进行检测,操作严格按照各厂家要求进行。观察比较两种检查方法的检测阳性率及敏感性和特异性。结果 TRUST法对梅毒的检测阳性率为80.77%(21/26),TPPA法对梅毒的检测阳性率为96.15%(25/26),TPPA检测法对梅毒检测的阳性率明显高于TRUST检测法(P<0.05)。TPPA检测梅毒的敏感性和特异性明显高于TRUST检查法(P<0.05)。且检测Ⅲ期梅毒及潜伏梅毒的阳性率分别均高TRUST检测的阳性率,两组比较差异具有显著性。结论 TPPA的敏感性和特异性优于TRUST检测法是临床常用的梅毒确诊试验,但其不适合大量标本的筛查,更适合用于TRUST测定阳性后的确诊试验,建议临床检验医师应予以注意。

Objective To investigate the use of gelatin particle agglutination test,respectively（TPPA）and the toluidine red unheated serum test（TRUST）of two methods of syphilis serology in the application.Methods In our hospital from January 2005 to December 2009,26（copies）of serum samples for the study of syphilis,according to the diagnostic criteria of syphilis[2]：10 cases of primary syphilis among Ⅰ,Ⅱ 9 cases of syphilis,Ⅲ of syphilis 4 cases,3 cases of latent syphilis;Another 10 patients with clinical identified as rheumatoid arthritis,hepatitis,SLE,tuberculosis as a control group;and 10 healthy subjects for the study.46 cases of samples by gelatin particle agglutination test（TPPA）and the toluidine red unheated serum test（TRUST）to perform detection of two methods,operating in strict accordance with the manufacturers requirements.Comparison of two methods of observation of positive rate and the sensitivity and specificity.Results TRUST method was tested positive for syphilis 80.77%（21/26）,TPPA method of syphilis testing positive rate was 96.15%（25/26）,TPPA test method Syphilis testing was significantly higher than TRUST detection（P0.05）.TPPA test the sensitivity and specificity of syphilis was significantly higher than TRUST Test（P0.05）.And the detection of syphilis and latent syphilis Ⅲ positive rates were higher than TRUST positive rate of detection of difference between two groups was significant,indicating TPPA test for stage Ⅲ and latent syphilis.Conclusion TPPA TRUST better sensitivity and specificity of detection,is commonly used in clinical diagnosis of syphilis testing,but not suitable for screening a large number of specimens,more suitable for TRUST diagnosed after the determination of positive tests,clinical laboratory physicians should be proposed Note.