化学发光微粒子免疫分析法对梅毒螺旋体特异性抗体的检测价值探究

Significance of chemiluminescent microparticle immunoassay in detecting treponema pallidum specific antibody

目的:研究化学发光微粒子免疫分析法(CMIA)对梅毒螺旋体特异性抗体的检测,评价其检测效果,探讨其临床适用性。方法:选择2011年5月～2012年5月在我院就诊的门诊和住院260例患者,分别使用梅毒螺旋体胶凝试验(TPPA)法与CMIA法病人血清,观察两种方法测定的阳性率,并以TPPA法为标准,评价CMIA法的敏感性、特异性、阴性预测值及阳性预测值。结果:CMIA法检出率为16.2%,而TPPA法检出率为14.6%,两种方法的阳性检出率比较,差异无统计学意义(P>0.05);CMIA法敏感性100%,特异性98.2%,阳性预测值90.5%,阴性预测值100%,CMIA法与TPPA法检测梅毒螺旋体抗体的符合率为98.7%。结论:CMIA具有自动化、检测周期短等特点,可以为梅毒抗体进行实验室批量检测。其与梅毒螺旋体胶凝试验的检出率相当,特异性也较高,可以结合TPPA及临床资料用于梅毒的确诊,在临床长期推广应用。

Objectives： To study the value of chemiluminescent microparticle immunoassay （CMIA） in the detection of specific antibodies to Treponema pallidum and to discuss its clinical applicability. Methods： We selected 260 patients who came to our hospital for outpatient and inpatient service from May 2011 to May 2012. Patients＇ serum was examined with gelling test Treponema pallidum （TPPA） and CMIA method to compare the positive detection rates of the two methods. TPPA was set as a standard to evaluate the sensitivity, specificity, negative predictive value, and positive predictive value of CMIA method. Re- suits： The detection rate of CMIA method is 16.2%, while the rate of TPPA method is 14.6%. There is no statistical difference between the two groups in the positive detection rates （ P 〉 0.05 ）. The sensitivity of CMIA method is 100%, specificity 98.2% , positive predictive value 90.5%, and negative predictive value 100%. The consistence rate between CMIA and TPPA method in detecting Treponema pallidum antibodies was 98.7%. Conclusions： The CMIA is characterized by automation, short detection period and can be used in laboratory batch testing for syphilis antibodies. The detection rate of CMIA has no significant difference from that of Treponema pallidum gelling test while its specificity is higher. TPPA in combination with clinical data can be used in the diagnosis of syphilis in clinical settings.