不同检测方法在孕妇梅毒筛查中的应用价值和监测意义

Value and significance of different methods in serological screening of syphilis among pregnant women

目的:探讨合理选择孕妇梅毒血清学筛查的有效方法,提高筛查的敏感性和特异性。方法:对11276例孕妇同时采用甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体抗体酶联免疫吸附试验(TP-ELISA)进行梅毒血清学检测,阳性标本采用梅毒螺旋体明胶凝集试验(TPPA)进行确证,对检测结果进行比较分析。结果:11276例孕妇中TRUST阳性28例,占受检总数0.25%;TP-ELISA阳性76例,占受检总数0.67%;TPPA阳性74例,占受检总数0.66%,TRUST、TP-ELISA、TPPA三种检测方法均阳性占0.25%。结论:对于首次进行孕检的人群,宜选用TP-ELISA进行筛查,提高初检结果的检出率和可靠性,做到早发现、早诊断、早治疗。TP-ELISA阳性标本以TPPA确诊,TPPA确诊标本再查TRUST滴度试验,以便于观察疗效、判断复发及再感染,提高遗传优生率。

Objective：To investigate effective methods to increase the sensitivity and specificity of the serological screening test of syphilis among pregnant women.Methods： Serological screening tests of syphilis among 11276 pregnant women were detected by using toluidine red unheated serum test（TRUST） and treponemal pallidum-enzyme linked immunosorbent assay（TP-ELISA）,then the positive cases were detected by treponemal pallidum particle assay（TPPA）.Results： Among 11276 pregnant women,28 cases were positive by TRUST（positive rate 0.25%）,76 cases were positive by TP-ELISA（positive rate 0.67%） and 74 cases were positive by TPPA（positive rate 0.66%）.Twenty-eight cases were found all positive by TRUST,TP-ELISA and TPPA（0.25%）.Conclusion： TP-ELISA can be applied in screening of syphilis among the pregnant women during the first pregnant test,which can increase the detection rate and reliability for early discovery,diagnosis and treatment.The cases of TP-ELISA positive should be detected by TPPA to make a definite diagnosis.The definite cases by TPPA should be detected by TRUST titer test so as to observe therapeutic effect,judge relapse and reinfection,and increase aristogenesis rate.