7800例新生儿TPPA和TRUST检测

Screening for congenital syphilis with TPPA and TRUST in 7800 neonates

目的 探讨非梅毒螺旋体抗原血清学试验和梅毒螺旋体抗原血清学试验检测胎传梅毒的价值及其临床实用性.方法 对门诊及住院7800例新生儿用甲苯胺红不加热血清试验（TRUST）做非特异性抗体定量检测,梅毒螺旋体明胶颗粒凝聚集试验（TPPA）做特异性抗体定性检测.统计分析确诊的胎传梅毒患儿初次梅毒血清学试验结果.比较TPPA和TRUST试验的敏感度和特异性.结果 进行血清学筛查的7800例新生儿中,初次梅毒血清学检测TPPA（＋）、TRUST（＋）60例,其中胎传梅毒患儿15例;初次梅毒血清学检测TPPA（＋）、TRUST（-）47例,其中胎传梅毒患儿5例.TRUST试验检测胎传梅毒的敏感率为75%（5/20）,特异性为99.41%（7734/7780）.TPPA试验检测胎传梅毒的敏感率为100%（20/20）,特异性为98.88%（7693/7780）.结论 TPPA比TRUST更适用于胎传梅毒的筛查.

Objective To assess the value and clinical applicability of non-treponemal antigen serologic test and Treponema pallidum antigen serologic test in the diagnosis of congenital syphilis. Methods Totally,7800 newborns were collected from the out-patient and in-patient department. Toluidine red unheated serum test （TRUST） was conducted to quantitatively detect non-treponemal antibodies and Treponema pallidum particle agglutination assay （TPPA） to qualitatively detect specific treponemal antibodies in these subjects. The results of first serology test for syphilis were assessed for neonates with confirmed congenital syphilis. The sensitivity and specificity in the diagnosis of congenital syphilis were compared between TPPA and TRUST.Results Of the 7800 newborns undergoing syphilis serology testa, 60 were positive for TPPA and TRUST,including 15 cases of congenital syphilis, 47 were positive for TPPA but negative for TRUST, including 5 cases of congenital syphilis. The sensitivity and specificity were 75% （5/20） and 99.41% （7734/7780） respectively for TRUST in the diagnosis of congenital syphilis, 100% （20/20） and 98.88% （7693/7780） respectively for TPPA. Conclusion TPPA seems more applicable than TRUST to the screening for congenital syphilis.