梅毒血清试验对梅毒诊断及疗效的临床价值

Clinical value of syphilis serology test for syphilis diagnosis and curative effect

目的:探讨3种梅毒血清学试验对梅毒诊断及疗效的临床价值。方法:对10711例血清标本用梅毒螺旋体抗体酶联免疫吸附试验(TP-ELISA)进行梅毒筛查,阳性标本进一步用梅毒螺旋体明胶颗粒凝集试验(TPPA)和甲苯胺红不加热血清试验(TRUST)滴度检测。结果:10711例血清标本进行TP-ELISA筛查,检出阳性441例,经TPPA法确诊阳性422例,阳性符合率为95169%。441例TP-ELISA阳性标本进行TRUST法检出阳性240例,阳性符合率为54142%,符合率明显低于TP-ELISA,差异有统计学意义(V2=402183,P<0105)。结论:TP-ELISA法敏感性较高,操作方便,可作为梅毒的常规筛查,但存在假阳性问题,尤其以60岁以上的老年人居多。TPPA法敏感性和特异性最高,作为确诊试验,但操作繁琐,不适合常规筛查。TRUST法敏感性和特异性均低于TP-ELISA法和TPPA法,仅可作为疗效观察和随访有无复发或再感染的指标。

[ Objective] To explore the clinical value of three kinds of syphilis serology test for syphilis diagnosis and curative el- feet. [Method]All of 10711 clinical speeimens underwent routine TP antibody screening with enzyme linked immunosorbent as- say （ELISA） method; positive samples were further tested by treponema pallidum particle agglutination （TPPA） and toluidine red unheated semnm test （TRUST） . [Result] 10711 serum samples were screened.there were 441 positive samples tested by TP- ELISA. Among them, the number of the same result tested by TPPA was 422 and the positive coincidence rate was 95. 69%. Among the 441 positive samples, 240 were positive results by TRUST, the positive coincidence rate was 54.42%. Posi- tive rate was significantly lower than TP - ELISA. There was significant difference （x^2 = 402.83, P 〈 0.05）. [ Condu- sion]TP- ELISA shows better sensibility, easy automation, as routine screening method, but it exists false positive, especially for old people of （ I〉60 years old）. The sensitivity and specificity of TPPA are highest, as confu-med diagnose test. However, the complicated operation TPPA is not suitable as a routine screening method. The sensitivity and specificity of TRUST are the lowest, only be as a curative effect observation and follow- up whether relapse re- infection indicators.