常用梅毒抗体检测方法的比较

Comparison of detection methods of syphilis antibodies

目的探讨不同梅毒抗体检测方学的敏感性和特异性。方法利用梅毒螺旋体胶凝试验(TPPA)、梅毒酶联免疫吸附试验(TP-ELISA)和梅毒螺旋体抗体快速血浆反应素试验(RPR)三种不同方法,对68份阳性标本及80份阴性标本分别进行检测,比较其敏感性和特异性。结果 TPPA、TP-ELISA和RPR三法的灵敏度分别为97.1%、94.1%、80.9%,特异性分别为97.5%、91.3%、88.8%,阳性预期值分别为97.1%、90.1%、85.9%,阴性预期值分别为97.5%、94.8%、84.5%。与灵敏度和特异性均较好的TPPA比较,RPR敏感性和特异性较低,敏感性差异有统计学意义(P<0.01),特异性间差异有统计学意义(P<0.05)。结论 TPPA不适合大规模的血液筛查,适用于对筛查后的阳性标本进行梅毒抗体的确证试验;TP-ELISA是目前筛查梅毒的理想方法;RPR检测梅毒非特异性抗体,用于疗效观察及过筛试验。

Objective To explore the sensitivity and specificity of different methods in detecting the antibody of treponema paUidum （TP）. Methods The antibody of TP in 68 positive and 80 negative specimen were detected using treponema pallidum particle agglutination assay （TPPA）, TP-ELISA and rapid plasma reagin assay （RPR）, respectively. The sensitivity and specificity of the three methods were compared. Results The sensitivity of TPPA, TP-ELISA, RPR were 97.1%, 94.1%, 80.9%, and the specificity was 97.5%, 91.3%, 88.8%, respectively. The positive predictive value were 97.1%, 90.1%, 85.9%, and the negative predictive value were 97.5%, 94.8%, 84.5%, respectively. Compared with TPPA with relative good sensitivity and specificity, RPR had significantly lower sensitivity and specificity （P〈0.01, P〈0.05）. Conclusion TPPA is suitable not for large-scale screening of blood, but confirmation test of syphilis antibody in positive specimens. TP-ELISA is the ideal method for screening of syphilis. RPR is suit- able for the detection of non-specific antibodies, observation of clinical efficacy and sieve test.