住院患者梅毒筛查方法探讨

Discussion of screening methods of syphilis for hospitalized patients

目的:比较梅毒螺旋体抗体颗粒凝集试验(TPPA)、梅毒酶联免疫吸附试验(ELISA)、微粒子化学发光免疫法(CMIA)、甲苯胺红不加热血清试验法(TRUST),探讨一种适合临床梅毒筛查的检测方法。方法:对5 710例临床患者血清标本分别用ELISA,CMIA,TRUST检测,阳性标本再进行TPPA确证实验。运用SPSS17.0统计软件对结果进行统计学分析。结果:ELISA检测出阳性标本128例,阳性率2.24%,TPPA复检阳性126例(126/128);CMIA检测出阳性标本132例,阳性率2.31%,TPPA复检阳性126例(126/132);TRUST检测出阳性标本38例,阳性率0.66%,TPPA复检阳性37例(37/38)。结论:CMIA,ELISA,TPPA三种方法阳性检出率比较,差异无统计学意义(P>0.05),TRUST与CMIA,ELISA,TPPA三种方法阳性检出率比较差异有统计学意义(P<0.05)。为了减少漏检,提高诊断率,应联合使用TRUST与CMIA或ELISA两种梅毒血清学试验检测方法。

Objective：To compare the consistency of treponema pallldum panicle agglutination（TPPA）,enzyme linked immunosorbent assay（ELISA）and ehemiluminescent micmparticle immunoassav（CMIA）,syphilis aniline red unheated serum reagin test（TRUST）,to investigate a suitable clinical syphilis screening mode. Methods：All 5 710 serum samples were detec-ted by CMIA,ELISA and TRUST. The positive samples were confirmed by TPPA. Statistical software SPSSl7. 0 was used for statistical analysis. Results：In 5 710 serum samples,128 were positive for ELlSA,the positive rate was 2. 24% ）,coincidence rate with TPPA was 126 / 128;132 were positive for CMIA,the positive rate was 2. 31% ,coincidence rate with TPPA was 126 /132;38 were positive for TRUST,the positive rate was 0. 66% ,coincidence rate with TPPA was 37 / 38. Conclusion：The posi-tive rate of CMIA,ELISA,TPPA has no significant difference（P 〉 0. 05）. The positive rate of TRUST and CMIA,ELISA,TPPA was statistically significant（P 〈 0. 05）. In order to reduce the missing,to improve the diagnostic rate,should be combined use of TRUST and CMIA or ELISA two kinds of test for syphilis detection method.