4种方法联合检测梅毒血清学试验结果分析

Analysis of the serological results of the combined detection for syphilis with four methods

目的观察及评价甲苯胺红不加热血清试验(TRUST)、酶联免疫吸附试验(ELISA)、胶体金法与明胶颗粒凝集试验(TPPA)4种方法联合检测梅毒血清学试验的效果。方法对本院2011年-2013年进行梅毒项目检测的70 265例住院患者的血清进行初筛,确诊的1 682例不同期梅毒患者的血清以TRUST、ELISA、胶体金法与TPPA联合筛查检测,4种试验中2种及以上试验阳性,判别为联合筛查试验阳性;以TPPA检测作为对照,计算4种方法检测各期梅毒的阳性率,对联合筛查试验和对照试验组结果进行比较分析。结果 TRUST各期梅毒的阳性率均低于其他3种方法,差异有统计学意义(P<0.05);ELISA、胶体金法潜伏期阳性率低于TPPA,差异有统计学意义(P<0.05);各期梅毒联合筛查阳性率与TPPA法对照组比较,经χ2检验结果显示2种试验结果一致。结论 TRUST、ELISA、胶体金法与TPPA联合筛查各期梅毒可以取长补短,结合病史与临床症状,可以进一步监测病情和疗效预测。

Objective To observe and evaluate the serological effect of the combined detection for syphilis with four methods, toluidine red unheated serum test （TRUST）, enzyme -linked immunosorbent assay （ELISA）, colloidal gold rapid testing and treponema pallidum particle agglutination（TPPA）. Methods Serum of 70 265 hospitalized patients were screened for syphilis detection from 2011 to 2013. With the methods of TRUST, ELISA, colloidal gold rapid testing and TPPA, 1 682 patients diag- nosed with syphilis of different phase were screened, as a result, two or more tests＇ positive judging of four kinds tests were regarded as the combined screening test positive. Calculate the positive rate of different phase syphilis with four kinds of methods, with TPPA as a control group, and then compare and analyze combined screening test and control test group results. Results The positive rate of all phases of syphilis with TRUST was lower than that of the other three methods, and the difference was statistically significant （ P 〈 0.05 ） ; the positive rate of latent syphilis with ELISA and colloidal gold rapid testing were significant lower than that of TPPA, and the difference had statistical significance（ P 〈 0.05 ）. The x2 test showed consistent results of the positive rate of syphilis with combined screening test and TPPA. Conclusion TRUST, ELISA, colloidal gold rapid testing and TPPA combined screening of syphilis can complement each other to monitor the disease and the efficacy of prediction with combining history and clinical symptoms.