多种不同梅毒检验方法检测梅毒螺旋体的结果准确率比较

Comparison of the accuracies of different methods for the detection of treponema pallidum

目的对比三种不同梅毒检验方法检测梅毒螺旋体的结果准确率。方法选取该院确诊各期梅毒的39例患者,同期就诊的30例乙型肝炎患者与体检的30例健康受试者。采用梅毒酶联免疫吸附法、梅毒螺旋体明胶颗粒凝集试验及梅毒甲胺红不加热血清反应素试验进行检测并比较其结果。结果梅毒甲胺红不加热血清反应素试验的假阳性率为2.02%,另外两种检验方法的假阳性率均为0%。梅毒甲胺红不加热血清反应素试验的总阳性率为87.18%,假阴性率为12.82%;梅毒酶联免疫吸附测定法的总阳性率为97.43%,假阴性率为2.56%;梅毒螺旋体明胶颗粒凝集试验的总阳性率为100.00%,假阴性率为0%。梅毒螺旋体明胶颗粒凝集试验的敏感度明显高于梅毒甲胺红不加热血清反应素试验以及梅毒酶联免疫吸附测定法的敏感度(P<0.05)。梅毒酶联免疫吸附测定法的敏感度明显高于梅毒甲胺红不加热血清反应素试验的敏感度(P<0.05)。结论根据临床诊断和治疗的不同需要,采用适宜的梅毒检测方法,以满足临床需求的同时,尽量减少患者的经济压力,促进医患关系的和谐发展。

Objective To compare three different methods for the detection of treponema pallidum. Methods 39 patients with syphilis were selected in our hospital,while 30 patients with hepatitis B and 30 healthy subjects were also selected. The treponema pallidum was detected by enzyme-linked immunosorbent assay,pallidum gelatin particle agglutination test and methylamine red unheated serum reagin test. Results The positive rate of methylamine red unheated serum reagin test was 87.18%, while the false negative rate was 12.82% ; the positive rate of enzyme-linked immunosorbent assay was 97.43%, while the false negative rate was 2.56% ;the positive rate of pallidum gelatin particle agglutination test was 100%, while the false negative rate was 0%. The sensitivity of pallidum gelatin particle agglutination test was higher than that of methylamine red unheated serum reagin test and enzyme linked immunosorbent assay （P 〈 0.05 ）. Conclusion The methylamine red unheated serum reagin test can be used for review and evaluation of efficacy of syphilis,the enzymelinked immunosorbent assay as a screening tool for syphilis, the pallidum gelatin particle agglutination test for diagnosis of syphilis.