3种梅毒螺旋体检测方法的比较与分析

The comparison study and analysis of three different methods of detecting treponema pallidum

目的对比研究3种不同的梅毒临床检测方法的敏感性和特异性。方法 2012年1月-2014年5月,收集梅毒确诊病例和非梅毒病例标本,血清标本采用酶联免疫吸附试验(TP-ELISA)和梅毒螺旋体明胶凝集试验(TPPA)检测,拭子标本采用荧光定量PCR(FQ-PCR)法检测,使用SPSS软件进行数据统计分析。结果 FQ-PCR、TP-ELISA、TPPA 3种梅毒检测方法的敏感度分别是99.37%、89.31%、98.11%。特异性分别为100.00%、97.09%、98.26%。敏感性比较差异有统计学意义(P<0.05),特异性比较差异无统计学意义(P>0.05)。在Ⅰ期梅毒病例中,TP-ELISA法阳性率显著低于FQ-PCR法和TPPA法。结论 3种方法都有各自的适用性和优越性,合理选用检测方法,可为梅毒的诊断、疾病的发展、疗效观察提供更快速准确的参考依据。

Objective To compare and study the sensitivity and specificity of 3 types of syphilis clinic detection methods.Methods The cotton swab samples and the serum samples of syphilis patients and non- syphilis patients from January 2012 to May 2014 was collected. The cotton swab samples was test by real- time fluorescent quantitative polymerase chain reaction（ RQ- PCR）. The serum samples were tested by TP- enzyme- linked immunosorbent assay（ TP- ELISA） and treponema pallidum particle agglutination test（ TPPA）. All the data was analyzed with SPSS software. Results The sensitivities of FQ-PCR,TP- ELISA and TPPA were 99. 37%,89. 31% and 98. 11%,respectively. The specificities of FQ- PCR,ELISA and TPPA were 100. 00%,97. 09% and 98. 26%,respectively. There was statistical significance in the sensitivity differences of 3methods（ P〈0. 05）,and there was no statistical significance in the specificity differences of 3 methods（ P〉0. 05）. For first-stage syphilis,the positive rate of TP- ELISA was significantly lower than that in FQ- PCR and TPPA. Conclusion FQ-PCR,TP- ELISA and TPPA had its own applicability and superiority. Reasonable choice of the detection methods will provide a more rapid and accurate reference for the clinical diagnosis of syphilis and the development of disease as well as the observation of curative effect.