四种试验方法检测早期梅毒患者的结果分析

Analysis of four methods for detection of early syphilis patients

目的了解镀银染色法、聚合酶链式反应(PCR)、梅毒甲苯胺红不加热血清试验(TRUST)和梅毒明胶颗粒凝集试验(TPPA)等4种方法,对检测早期梅毒患者的临床价值。方法 2012年1月至2016年7月,在广西部分地区的性病门诊收集疑似早期梅毒患者300例,分别采集组织液与血清标本。组织液标本采用镀银染色法检测梅毒螺旋体,PCR方法检测TP polA基因;血清标本用于TRUST检测非梅毒螺旋体抗体,TPPA检测梅毒螺旋体抗体。统计学资料采用SPSS 13.0软件进行分析。结果在215例确诊的早期梅毒患者中,梅毒PCR检测阳性标本210例,敏感性为97.7%;镀银染色法检测出105例,敏感性为48.8%;TRUST检测出196例,敏感性为91.2%;TPPA检测出208例,敏感性为96.7%。结论不同试验检测方法对早期梅毒患者的诊断有不同的临床应用价值,一期梅毒应当做病原学检查及梅毒血清学试验,二期梅毒应当以梅毒血清学试验为主,当出现结果异常时,应要求患者进行随访再检测以明确诊断。

Objective To evaluate clinical value of four methods （silver staining, PCR, TRUST and TPPA） to identify early syphilis patients. Methods From January 2012 to July 2016, 300 suspected cases of early syphilis in different regions of Guangxi STD clinics were recruited in our study, with tissue fluid collected for PCR and silver staining, and serum for TRUST and TPPA. Results 215 patients were identified as the real early syphilis. The sensitivity of PCR testing was 97.7% and silver staining 48.8%, the sensitivity of TRUST 91.2% and TPPA 96.7%. Conclusion Different methods used for the diagnosis of early syphilis patients have different clinical values. The primary syphilis should he diagnosed by pathogenic examinations and serological tests. Secondary syphilis should be diagnosed by serological tests. When inconsistent results appear in these tests, we need to ask patients to receive the follow-up test for a definite diagnosis.