三种梅毒血清学试验在梅毒诊断中的临床对比研究

Three kinds of syphilis serological tests in the diagnosis of syphilis

目的:分析并比较甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体明胶凝集试验(TPPA)以及酶联免疫吸附试验(TP-ELISA)三种梅毒血清学试验在梅毒诊断中的应用价值。方法:选择我院2011年1月至2013年3月收治的220例梅毒患者以及同期在我院进行健康体检的600名健康成人为研究对象,采用TRUST、TPPA、TP-ELISA方法对其进行梅毒血清学试验,比较三种检测方法测定的灵敏度、特异性和正确率。结果:TRUST、TPPA和TP-ELISA三种梅毒血清学检查方法的检测特异性均较高,而TPPA和TP-ELISA方法的检测灵敏度显著高于TRUST法,差异具有统计学意义(P<0.05)。结论:TP-ELISA方法操作简便,检测准确率较高,灵敏度和特异性均较好,可用于梅毒筛选;TRIST方法可用于对既往存在梅毒的患者进行血清筛选;TPPA方法可用于梅毒确诊。

Objectives： To analyze and compare the clinical value of toluidine red unheated serum test （TRUST）, Trepo- nema pallidum gelatin agglutination test （TPPA） and enzyme -linked immunosorbent assay （TP -ELISA）. Method： 220 syphi- lis patients presenting in our hospital and 600 healthy adults having medical examination from January 2011 to March 2013 were selected as the research objects to conduct syphilis serological tests by using TRUST, TPPA, TP - ELISA to evaluate the sensitivi ty, specificity and accuracy. Results： The three methods all had high detection specificity, while the detection sensitivity of the TPPA and TP - ELISA methods was significantly higher than that of TRUST method, with statistically significant difference （ P 〈 0. 05 ）. Conclusion： TP - ELISA method is easy to operate, with high accuracy, sensitivity and specificity, which can be used in syphilis screening; TRIST method can be used for patients with preexisting syphilis serum screening and TPPA method can be used in the diagnosis of syphilis.