TPPA定量试验在胎传梅毒诊断中的应用

Application of the quantitative test for Treponemal pallidum particle agglutination in the diagnosis of congenital syphilis

目的:评价梅毒螺旋体颗粒凝集试验(TPPA)定量检测在胎传梅毒诊断中的作用。方法:对确诊梅毒的155例孕产妇及其所生新生儿进行TPPA和快速血浆反应素环状卡片试验(RPR)定量检测,以18个月婴儿随访TPPA试验结果阳性作为胎传梅毒最终诊断标准。结果:155例新生儿经18个月随访最终确诊胎传梅毒27例。155例新生儿与其生母TPPA滴度之比≥4者14例,其中13例为胎传梅毒,灵敏度为48.15%(95%CI:29.30%~67.00%);新生儿与其生母RPR滴度之比≥4者7例,其中6例为胎传梅毒,灵敏度为22.22%(95%CI:6.54%~37.90%);两者差异有统计学意义(P=0.046)。两种方法的特异度均为99.22%。结论:TPPA定量试验较RPR定量试验可显著提高胎传梅毒的确诊率。

Objective：To assess the effect of the quantitative test for treponemal pallidum particle aggluti-nation （ TPPA） in the diagnosis of congenital syphilis. Methods： TPPA and rapid plasma regain （ RPR） in 155 pregnant women with syphilis and their neonates were performed. The positive of TPPA was taken as the diagnosis standard for congenital syphilis at 18 months after birth. Results：Twenty seven cases with congenital syphilis were ultimately diagnosed. The TPPA titer ratio of neonate-mother was greater than 4 in 14 cases, of which 13 were patients with congenital syphilis. The sensitivity of TPPA titer ratio of neonate-mother for the diagnosis of congenital syphilis was 48.15% （95% CI：29.30%-67.00%）. The RPR titer ratio of neonate-mother was greater than 4 in 7 cases, of which 6 were the patients with congenital syphilis. The sensitivity of RPR titer ratio of neonate-mother for the diagnosis of congenital syphilis was 22. 22% （ 95% CI：6. 54%-37.90%） . There was a significant difference in the sensitivity between TPPA and RPR titer testings for the di-agnosis of congenital syphilis （ P = 0. 046 ） . The specificity of the two methods was 99. 22% in each. Conclusion：The accuracy of quantitative test for TPPA is greater than RPR in the diagnosis of congenital syphilis.