6种非梅毒螺旋体抗原血清学试验试剂对梅毒患者随访的影响

Impact of six non-treponemal syphilis serological tests on follow-up of syphilis cases

目的探讨几种非梅毒螺旋体抗原血清学试验试剂对梅毒患者随访的影响。方法按照非梅毒螺旋体抗原血清学定量试验稀释样本的原则,充分稀释11份梅毒患者血清,每份连续稀释成12个浓度,用1种梅毒快速血浆反应素环状卡片试验(RPR)和5种梅毒甲苯胺红不加热血清试验(TRUST)试剂检测稀释好的血清,观察不同试剂对样本的反应性。结果 6种试剂对同一份样本的检测能力不尽相同,RPR试剂与5种TRUST试剂的检测结果基本不相同,两者无可比性。TRUST试剂之间只有2种试剂的结果相似,其他的差异较大,甚至同一份样本的最高滴度是最低滴度的16倍。对所有样本来说,某些试剂检测的滴度有总体偏低或偏高的趋势。结论不同方法或不同厂家的同一方法对梅毒患者个体的治疗随访有影响,相互间检测结果不能互认,因此临床实验室在梅毒的诊断、治疗和随访中,要注意使用相同的非梅毒螺旋体抗原血清学试验试剂。

Objective To investigate the impact of non-treponemal syphilis serological tests on follow-up of syphilis cases.Method The srea of 11 syphilis cases were diluted according to the principle of non-treponemal syphilis quantitative test,and each specimen was serially diluted to 12 concentrations,and detected by one rapid plasma reagin test（RPR） and five toluidine red unheated serum tests（TRUST）.Result The detectability of 6 reagents of non-treponemal syphilis tests were shown to be different from each other,the quantitative results were shown to be different between the reagents of RPR and 5 TRUSTs,and the results were not comparable between these two reagents.Only two reagents of TRUST were shown to have the same detectability,while the others were otherwise,even though the highest titer of one sample were 16 times higher than the lowest titer of the same sample.For all the samples,some reagents tended to show too high or too low titers by and large.Conclusion Different methods or the same method from different manufacturers have impact on follow-up of syphilis cases,and their results can not be recognized mutually.So we should use the same non-treponemal syphilis reagent in diagnosis,treatment and follow-up of syphilis cases.