不同梅毒血清学检测方法的比较及临床应用

Comparison of different methods of serological testing for syphilis and its clinical value

目的探讨3种不同的梅毒血清学检测方法在梅毒诊断和治疗中的临床价值。方法对本院2008~2010年6 614份输血前筛查和性病门诊标本同时用梅毒酶联免疫吸附试验（ELISA）和梅毒螺旋体明胶凝集试验（TPPA）进行检测,对ELISA法和TPPA法阳性的标本再分别进行甲苯胺红不加热血清试验（TRUST）检测其滴度。结果 ELISA法检测出247份阳性,TPPA法检测出244份阳性,TPPA法阳性标本ELISA法检测均为阳性,符合率为98.78%,两种方法检出率比较差异无统计学意义（P〉0.05）;对ELISA法阳性标本用TRUST法检测出136份阳性,符合率55.06%;TPPA法确证实验阳性的标本TRUST法检测出136份阳性,符合率55.74%;TRUST法与ELISA法和TPPA法检出率比较,差异均具有统计学意义（P〈0.05）。结论由于梅毒检测方法众多,且各种方法的敏感性和特异性也不尽相同,通过对3种检测方法的比较分析,在进行梅毒的诊断和治疗中,应联合使用不同的梅毒血清学方法进行检测。

Objective To explore three different serological detection of syphilis in syphilis diagnosis and treatment of clinical value.Methods From 2008 to 2010,6 614 samples collected in transfusion department and the STD of our hospital were tested by enzyme-linked immunosorbent assay（ELISA） and treponema pallidum particle assay（TPPA）.Then the positive samples were detected by toluidine red unheated serum test（TRUST） and tested the titer.Results ELISA method detected 247 positive samples,TPPA method detected 244 positive samples,and the coincidence rate of positive samples tested by TPPA method ELISA was 98.78%,the detection rate between the two was not significantly different（P〈0.05）;136 out of the positive samples tested by ELISA were positve by TRUST method,with positive coincidence rate of 55.06%;136 out of the positive samples tested by TPPA were positve by TRUST method,with positive coincidence rate of 55.74%.There were significant differences of detection rate among TRUST method,ELISA method and the TPPA method（P〈0.05）.Conclusion There are many methods to detect syphilis,and the sensitivity and specificity of each method are not the same,through the comparative analysis of three detection methods,the diagnosis and treatment of syphilis should be combined with different methods of syphilis detection.