4种梅毒血清学检测方法评价

Applicable value of combined detection of four methods for the diagnosis of syphilis

目的了解1 622例患者梅毒感染状况并合理选择实验方法。方法同时用非特异性苯胺红快速血浆反应素试验(TRUST)检测血清中反应素,梅毒螺旋体明胶凝集试验(TPPA)、微粒子化学发光免疫分析法(CLIA)及荧光梅毒螺旋体吸收试验(FTA-ABS)检测血清中梅毒特异性抗体。结果 1 622例患者TRUST检出梅毒阳性185例,占总数的11.4%,185例阳性者用TPPA检测出169例阳性,占总数的10.4%,CLIA检测出173例阳性,占总数的10.7%,FTA-ABS检测出175例阳性,占总数的10.8%。结论 TRUST阳性率较高,但存在一定的生物学假阳性,虽操作简便,但只能作为筛查,必须做TPPA、FTA-ABS确认,以减少梅毒的误诊和医疗纠纷。

Objective To explore applicable value of combined detection of four methods,including toluidine red unheatect serum test （ TRUST）, treponema pallidum particle agglutination assay（ TPPA）, chemiluminescent microparticle immunoassay （CLIA） and fluorescent treponemal antibody absorption test（FTA ABS）,for the diagnosis of syphilis. Methods The 1 622 clinical specimens underwent routine treponema pallidum antibody screening with four methods. All TRUST positive samples were further confirmed by TPPA,CLIA and FTA ABS. Results Among 185 treponema pallidum antibody screening positive specimens, 169 samples were confirmed positive by TPPA, 173 samples were confirmed positive by CLIA, 175 samples were confirmed positive by FTA ABS and the positive coincidence rates of TRUST,TPPA,CI.IA and FTA ABS were 11.4%,10.4%,10.7% and 10.8% respeclively. Conclusion High rate of TRUST false positive result existed in syphilis screening test. All TRUST positive samples should be further tested by TPPA and FTA ABS so as to reduce the misdiagnosis and medical dispute in diagnosis of syphilis.