梅毒感染及与艾滋病共感染对梅毒检测结果的影响

Influence of syphilis infection and syphilis and HIV co-infection on the detection results of the different syphilis detection methods

目的通过对本市医院就诊者、血站献血者和市疾病预防控制中心(CDC)艾滋病梅毒项目的检测,对目前常用的5种梅毒检测方法进行结果比较,探讨实验室如何选择不同的检测方法。方法对2010年来我市中心医院就诊者进行梅毒检测、2010年中心血站筛查出的梅毒阳性样本和我市CDC检测出的艾滋病梅毒共感染样本组成血清盘,用快速血浆凝集试验(RPR)、甲苯胺红不加热血清试验(TRUST)、梅毒胶体金(SYP)、酶联免疫(ELISA)、明胶颗粒凝集试验(TPPA)进行检测,用χ2检验分析结果。结果梅毒胶体金(SYP)、酶联免疫(ELISA)、明胶颗粒凝集试验(TPPA)阳性检出率比较,差异无统计学意义(P>0.05);快速血浆凝集试验(RPR)、甲苯胺红不加热血清试验(TRUST)阳性检出率比较,差异显著(P<0.05);快速血浆凝集试验(RPR)、甲苯胺红不加热血清试验(TRUST)对二期梅毒的阳性检出率与TPPA有很好的吻合性,对一期梅毒次之,治疗后检出率最低。梅毒胶体金(SYP)有较好的特异性,但假阳性率较高。艾滋病与梅毒共感染组和梅毒单纯感染组对梅毒的检出率没有显著性差异。结论 TPPA用来做实验室梅毒的确证试剂;酶联免疫(ELISA)检测梅毒应该作为大批检测的首选;梅毒胶体金(SYP)主要用于急诊病例;快速血浆凝集试验(RPR)、甲苯胺红不加热血清试验(TRUST)不推荐作为梅毒筛查试剂,主要用来与特异性结果配合,判断患者是否是现症梅毒或梅毒的疗效判断。除艾滋病晚期患者免疫力极度低下的情况外,是否感染艾滋病对梅毒的检出没有影响。

Objective To compare the detection results of different syphilis detection methods by the issued data of hospital clients, the blood donors and the CDC AIDS syphilis project testing of the center, and to discuss how to choose the different laboratory test methods in the syphilis and AIDS detection. Methods In 2010, the hospital clients in our city, the syphilis positive screening out of blood donation and the CDC detect syphilis infection with the AIDS of blood samples were done syphilis diction with the fast plasma agglutinate experiment （RPR）, a red do not heat serum test aniline （TRUST）, syphilis colloidal gold （SYP）, enzyme league immune （ELISA）, gelatin particles agglutinate experiment （TPPA）, and the test was analyzed with the chi-square test. Results The difference was not statistically significant （ P 〉 0.05） in the positive detection rates among syphilis colloidal gold （SYP）, enzyme league immune （ELISA）, gelatin particles agglutinate experiment （TPPA） positive detection rate is, ; Rapid plasma agglutinate experiment （RPR）, a red do not heat serum test aniline （TRUST）. There existed the significant difference （ P 〈 0.05） between fast plasma agglutinate experiment （RPR） and a red do not heat serum test aniline （TRUST） and the results inosculated with the experimental data TPPA in the second phase of syphilis positive detection rate, the results of the first phase of syphilis took？second？place, the detection results after a period of treatment was lowest. Syphilis colloidal gold （SYP） had good specificity, but the false-positive rate was high. There was no significant differences between syphilis infection and AIDS and syphilis co-infection. Conclusion PPA can be used as the reagents to make laboratory syphilis conclusive evidence of; enzyme league immune （ELISA） test should be as large quantities of syphilis detection; syphilis colloidal gold （SYP） is mainly used in emergency cases; rapid plasma agglutinate experiment （RPR）, a red do not heat serum test aniline （TRUST） is not recommended as a syphilis screening reagent, mainly used for the specific results cooperation to judge whether patients have the existing symptom syphilis or the judgment of the curative effect of syphilis. In addition to AIDS patients with extremely low immunity at the late situations, but whether they have infected with HIV has no influence in syphilis detection.