梅毒感染人群中3种血清学检测方法与结果分析

Analysis of the three kinds of serological tests on patients with syphilis

目的通过用3种血清学方法对本地性病门诊高危人群梅毒感染情况的研究,一方面了解高危人群梅毒感染率,另一方面评价3种方法在梅毒血清筛查中的运用。方法用酶联免疫吸附法(TP-ELISA)、明胶颗粒凝集法(TPPA)、甲苯胺红不加热血清试验(TRUST)3种方法分别对高危人群352例进行筛查,用χ2检验分析结果。结果 TRUST检测结果显示男性阳性率为15.7%,女性阳性率为17.1%,总体阳性率为16.8%;TP-ELISA检测结果显示,男性阳性率为14.9%,女性阳性率为15.9%,总体阳性率为15.6%;TPPA检测结果显示,男性阳性率为13.1%,女性阳性率为15.9%,总体的阳性率为15.0%。对3种检测结果进行χ2检验,结果显示男性阳性率、女性阳性率以及总体阳性率3种检测结果差异无统计学意义。结论该地高危人群梅毒感染率较高。梅毒3种血清学方法显示灵敏度均符合临床需要,TPPA特异性较好,3种方法均存在一定的假阳性率。一般来说3种方法中任何一种都可用来做梅毒中期筛查实验,梅毒早期最好选择ELISA方法,确诊实验应选择TPPA的方法。

Objective To study the infection status of syphilis in our sexually transmitted diseases（STD） outpatients by using three serological methods,and to learn about the syphilis infection rate of high risk population,and to evaluate the three methods in syphilis screening.Methods Methods of TP-ELISA,TP-PA and TRUST were used to do syphilis screening respectively in 352 high risk patients,and chi-square statistics was used to analyze the results.Results The positive rates were as follows：the results of method TRUST showed positive rate of 15.7% in male while 17.1% in female,16.8% in total;the results of TP-ELISA showed positive rate of 14.9% in male while 15.9% in female,15.6% in total;the results of TP-PA showed positive rate of 13.1% in male while 15.9% in female,15% in total.There was no significant difference in the positive rates of male,female and total among the three methods.Conclusion There is a high infection rate of syphilis in the high risk population of this area.The sensitivities of three serological methods can meet the demand of clinic,but certain false positive rate exists in all of the three methods,while TPPA has a higher specificity.In general,any of these can be used for the screening of secondary syphilis,but ELISA is the best choice for detecting primary syphilis while TPPA is the best choice to confirm.