血液筛查实验室梅毒实用性筛查方案的探讨

Study on practical programs for syphilis examination in blood screening laboratories

目的对梅毒螺旋体抗体胶体金法和酶联免疫吸附试验(ELISA)法和梅毒螺旋体抗体诊断凝集法(TPPA)3种实验方法进行应用评价,然后对梅毒的筛查方案进行探讨。方法收集ELISA梅毒检测阳性的标本用胶体金法和TPPA方法进行检测,然后对结果进行比较。结果 ELISA方法进行梅毒检测阳性的标本共147例,其中用胶体金法方法检出79例,占54%(79/147);TPPA方法检出89例,占61%(89/147)。结论胶体金法其特异性高但灵敏度低,可以用于采血前初筛检测,ELISA方法可以用于血液采集后的初复检筛查,最后用特异性好的TPPA方法进行确认,这种针对血液中梅毒抗体的筛查方案是从保证血液的安全性、操作的方便性和经济性3个方面来考虑的。

Objective To evaluate the three experimental methods of treponema colloidal gold assay and enzyme-linked immunosorbent assay（ELISA） and treponema pallidum particle agglutination assay（TPPA） detection on treponema pallidum antibody,and then explore the syphilis screening program.Methods We collected positive samples of treponema pallidum antibody tested by ELISA,and tested these by colloidal gold and TPPA and then compared the results.Results Among 147 ELISA-positive patients in test group,89 were confirmed by TPPA and the positive coincidence rate was 61%（89 /147）.79 were positive by colloidal gold and the positive coincidence rate was 54%（79/147）.Conclusion Colloidal gold assay with high specificity but low sensitivity,can be used for screening test,ELISA method can be used as a screening method after blood collection,TPPA is performed as a confirmatory test.The screening programs for treponema pallidum antibody detection in blood are to ensure the safety of the blood,the operation of the convenience and economy of three to consider.