梅毒螺旋体感染四种血清学检测方法的临床评价

Four methods of serological screening forTreponema pallidum infection

目的:比较四种梅毒血清学实验诊断方法的准确性及在临床的应用价值;对ELISA法检测老年人梅毒抗体易产生假阳性的现象进行分析研究。方法:应用甲苯胺红不加热血清试验(TRUST),梅毒密螺旋体明胶凝集试验(TPPA),梅毒酶联免疫吸附试验(TP-ELISA)及梅毒抗体蛋白印记法(West-ern-blot)检测660例患者血清。结果:TRUST方法特异性及敏感性较低;Western-blot、ELISA与TPPA三种方法在检测梅毒抗体时灵敏度与特异性均较好,尤其是Western-blot特异性达到100%,且TPPA的敏感性比Western-blot、ELISA法稍差。ELISA检测老年人梅毒抗体有产生假阳性的现象。结论:ELISA法因其准确性及方法学的优势,为目前梅毒大批量标本血清学检测的筛查方法;TPPA及Western-blot可作为梅毒血清学检测的确诊方法。

Objective： To compare sensitivity and specificity of four kinds of serological approaches for detecting Treponema pallidum antibody and to analyze false-positive status of ELISA in detecting antibody against syphilis in the senile. Methods：Four approaches including TRUST, TPPA, TP-ELISA and Western-blot were used to detect the serum specimens from 660 subjects. Results. Among the four approaches, TRUST was found to be the least efficient and sensitive one. The sensitivity and specificity of Western-blot, TPPA and ELISA were fairly good, moreover, the specificity of Western-blot was up to 100%, and TPPA was found to be less sensitive than Western-blot and ELISA. There was a phenomenon of the false positive for ELISA detecting of antibody against syphilis of the senile. Conclusions. It is suggested that the approach of TP-ELISA should be as a screening test for detecting Treponema pallidum antibody at present. Both TPPA and Western-blot could be used as confirmatory tests.