四种梅毒血清学检测方法辅助诊断梅毒的临床意义

CLINICAL EVALUATION OF FOUR KINDS OF SEROLOGICAL TESTING METHODS FOR SYPHILIS DIAGNOSIS

目的比较四种梅毒血清学检测方法在梅毒确诊时的临床意义。方法收集因婚前检查或孕前检查时梅毒血清学筛查阳性并进一步至该院就诊确诊的患者血标本共32份,同时应用梅毒螺旋体明胶颗粒凝集试验(TPPA)、梅毒甲苯胺红不加热血清反应素试验(TRUST)对患者血清标本进行检测。乙肝五项、AIDS均进行检测,综合分析最终确诊是否患梅毒。结果 (1)TPPA筛查实验阳性者共9例,该院检测TPPA、TRUST后5例诊断为隐性梅毒,4例诊断为既往感染梅毒。(2)梅毒酶联免疫吸附测定法(TPELISA)阳性者共7例,该院检测后1例诊断为隐性梅毒,6例诊断为既往感染梅毒,已自愈。(3)快速血浆反应素试验(RPR)阳性者共9例,该院检测后诊断7例为梅毒,2例为假阳性。(4)TRUST筛查实验阳性者共7例,该院确诊3例为隐性梅毒,4例假阳性。结论四种梅毒血清学检测方法单独使用均不能确诊梅毒,需联合检测以提高临床诊断符合率。

Objective To evaluate the clinical application of four kinds of serological testing methods in the diagnosis of syphilis.Methods Thirty-two serum samples were collected from patients who had positive results of syphilis screening.All serum were checked by TPPA,TRUST,HBsAg and AIDS.Results There were 9 patients whose syphilis screening by TPPA was positive,among them 5 patients were diagnosed as syphilis latent,4 patients had cured syphilis.There were 7 patients whose syphilis screening by TP-ELISA was positive,among them 1 patient were diagnosed as syphilis latent,6 patients had cured syphilis.There were 9 patients whose syphilis screening by RPR was positive,among them 7 patients were diagnosed as syphilis,2 patients had false positive results.There were 7 patients whose syphilis screening by TRUST was positive,among them 3 patients were diagnosed as syphilis,4 patients had false positive results.Conclusion These four tests can not be used alone to diagnose syphilis,we should combine the different detection methods to improve the clinical diagnostic coincidence rate of syphilis.