不同血清学检测方法对梅毒螺旋抗体检测效果对比分析

The effects of five varied serological assay in detecting of treponema antibody

目的对比分析五种不同检测方法的特异性、灵敏性,为临床对梅毒螺旋体的检测提供参考依据。方法 140例门诊梅毒病人作为阳性组、再选取同期我院接收治疗非梅毒病人作为阴性组(140例)。利用梅毒螺旋体明胶凝集实验(TPPA)、梅毒苯胺红不加热血清反应素试验(TRUST)、梅毒螺旋体血凝实验(TPHA)、梅毒螺旋体特异性抗原血清实验(RPR)、梅毒酶联免疫吸附测定(ELISA)五种检测方法进行重复检测。比较五种方法在阳性组中检测出的阳性率、特异性率、灵敏度以及阴性组中检测出的假阳性率。结果 ELISA组具有最高的阳性率(97.14%),显著高于除TPPA组之外的其他三种检测方法(均P<0.05),但假阳性率也较高(10.71%),TPPA假阳性率最低(0.00%),显著低于其他检测方法(均P<0.05);TRUST灵敏度(85.62%)和特异性(88.64%)最低,均显著低于其他检测方法(均P<0.05)。结论综合比较,TPPA法用于检测梅毒螺旋抗体阳性率高、假阳性率低、特异性机灵敏度均较高、综合效果最好。ELISA阳性率最高、但易出现假阳性,TRUST不适合用于梅毒螺旋抗体检测。

Objective To compare the specificity and sensitivity of five varied kinds of detection methods known as TPPA, TPHA, RPR, ELISA, TRUST so as to obtain scientific knowledge for detecting Treponema pallidum. Methods 140 patients with syphilis admitted to our hospital from January 2012 to July 2013 were selected as the experimental group of study. Another patients tested as negative of syphilis were chosen as the control group of study. Five varied methods, namely, Treponema pallidum gelatin agglutination test （TPPA）, syphilis aniline red unheated serum reagin test （TRUST）, Treponema pallidum hemagglutination test （TPHA）, Treponema pallidum-specific antigen serum test （RPR）, syphilis enzyme-linked immunosorbent assay （ELISA）, were employed for duplicate detection. The positive rate, specificity rate, sensitivity and detected false positive rate of the five methods were compared. Findings ELISA group has the highest positive rate （97.14%） ,significantly higher than outside the group unless TPPA other three detection methods（ both P 〈0.05）. However, the false-positive rate was also higher （10.71%）. TPPA lowest false positive rate （0. 00% ） was significantly lower than other detection methods （ P 〈 0.05 ） ; TRUST sensitivity （85.62%） and specificity （ 88.64% ） the lowest , were significantly lower than other detection methods （both P 〈 0. 05）. Conclusion comprehensive comparison, TPPA method for the detection of Treponema antibody positive rate, false positive rate, sensitivity, specificity machines are high and is the best. ELISA positive rate is highest, but has a high false positive. TRUST is not suitable for syphilis antibodies.