3种梅毒检测方法临床应用评价

Evaluation of clinic application using three reagents for detecting syphilis

目的:评价3种常用梅毒抗体检测方法在梅毒实验室质量控制中的应用价值,提高临床梅毒的检出率。方法:同时用快速血浆反应素实验(RPR)、梅毒螺旋体明胶凝集试验(TPPA)和酶联免疫吸附试验(TP-ELISA)检测155例梅毒螺旋体质控血清标本。比较3种梅毒血清学检测方法的敏感性和特异性。结果:RPR、TPPA和TP-ELISA的阳性检出率分别为50.32%,57.42%和64.52%;其敏感性和特异性分别为67.37%、84.21%、93.68%和76.67%、85.00%、81.67%。RPR、TPPA敏感性与TP-ELISA相比差异有统计学意义(P<0.05),RPR特异性低于TP-ELISA,二者间差异无统计学意义(P>0.05)。结论:TP-ELISA是理想的梅毒实验室检测方法,TPPA法可作为梅毒确证实验的补充,RPR方法可用于临床治疗梅毒的监测和筛查方法。

Objective： To evaluate application value of three examination methods for syphilis in laboratory quality control,and increase the recall ratio of clinical syphilis.Methods： We measured 155 serum samples in 155 samples for quality control in order to detect the presence of the treponema pallidum.This research was carried out by serological methods of rapid plasma reagin test（RPR）,gelatin agglutination test（TPPA） and enzyme linked immunoabsorbent assay（TP-ELISA）.The sensitivity and specificity of three serological methods were analysised.Results： RPR is positive for 50.32%,TPPA is detected in 89 cases （57.42%） and the TP-ELISA is positive in 100 cases（64.52%）.Relative sensitivity and specificity was 67.37% and 76.67% for RPR,84.21% and 85.00% for TPPA,93.68% and 81.67% for TP-ELISA,respectively.Comparing with TP-ELISA,the sensitivity of RPR and TPPA were shown significantly statistic difference（P0.05）.There was not obviously statistic difference in specificity between TP-ELISA and RPR（P0.05）.Conclusion： TP-ELISA was an ideal method in detecting syphilis because of good sensitivity and specificity.TPPA could be used as supplement for a confirmatory test of positive results and RPR was suitable for syphilis monitoring and screening.