梅毒实验诊断中增强化学发光技术与其它血清学比对以及在急诊筛查流程的探讨

Commparision of Enhanced Chemiluminescence Technologies with Other Syphilis Serology and the Application for Screening Procedure in a Stat Laboratory

目的 通过分析梅毒螺旋体血清学比对试验,探讨增强化学发光技术（enhanced chemiluminescence technologies,ECT）在急诊化验室筛查流程.方法 增强化学发光技术与梅毒螺旋体颗粒凝集试验（TP-PA）法同时检测2013年4月～2014年5月间257例患者血清标本梅毒螺旋体抗体,二者不相符的检测结果,使用梅毒快速血浆反应素环状卡片试验（RPR）和荧光螺旋体抗体吸收试验（FTA-ABS）进行验证.结果 ECT与TP-PA比对敏感度为98.9％,特异度为88％,二者具有较高的一致性（K=0.921,P＜0.05）;二者结果不符标本11例（4.28％）,ECT阳性TP-PA阴性的不符标本9例中,FTA-ABS IgG抗体9例均为阴性,RPR检测阳性1例;ECT阴性TP-PA阳性的不符标本2例,RPR检测与FTA-ABSIgG抗体均为阴性.经FTA-ABS验证后的ECT敏感度为100％,特异度为88.3％.结论 ECT敏感度高,特异度较好,且简便快速的方法学适用于急诊化验室梅毒血清学试验筛查.ECT阳性时,建议使用RPR检测以确定疾病的活动性.

Objective To analyze commparision of enhanced chemiluminescence technologies with other syphilis serology and the application for screening procedure in a stat laboratory. Methods Enhanced chemiluminescence technologies （ECT） and treponema pallidum particle agglutination assay （TP2PA） were used to detect treponemal antibody in 257 serum specimens from April 2013 to May 2014. Specimens with discordant results between ECT and TP-PA were re-tested for confirmation by FTA-ABS and rapid plasma regain test （RPR）. Results The sensitivity and specificity of ECT were 98. 9 %,88 %,if TP PA was used as a standard （K=0. 921 ,P〈0. 05）. There were 11 （4.28%） specimens with discordant results between ECT and TP-PA,9 of them were ECT positive/TP-PA negative,all nine were tested negative with FTA-ABS IgG antibody but one positive with RPR 2 of the nine were ECT negative/TP-PA positive,all were negative with FTA-ABS IgG antibody and RPR. The sensitivity and specificity of ECT increased to 100% and 88.3% respectively after the confirmation test of FTA- ABS. Conclusion The sensitivity of ECT was perfect and the specificity was good. RPR is recommended to be used to deter- mine the activities of diseases if initial screening results of ECT in a stat laboratory are positives.