酶联免疫吸附法与甲苯胺红不加热血清试验在梅毒检验中诊断价值的比较

Comparison of the diagnostic value of Enzyme-linked Immunosorbent Assay and Toluidine Red Unheated Serum Test for syphilis

目的比较酶联免疫吸附法(ELISA)与甲苯胺红不加热血清试验(TRUST)在梅毒检验中的诊断价值。方法随机选择2015年1月至2016年12月于该院进行梅毒检查的1 500例疑似病例进行临床研究。所有患者来诊后,使用梅毒螺旋体明胶凝集试验(TPPA)、ELISA、TRUST三种方法进行梅毒螺旋体检测。以TPPA法检测结果为金标准,判断ELISA与TRUST检测的灵敏度、特异度、阳性预测值、阴性预测值。结果 1 500例疑似患者中梅毒确诊患者为1 093例,排除患者407例。ELISA法检测的灵敏度、特异度、阳性预测值、阴性预测值分别为98.08%、96.07%、98.53%、94.09%,TRUST法检测分别为92.04%、87.22%、95.08%、80.32%。ELISA各项指标均高于TRUST,且差异有统计学意义(P<0.05)。结论 ELISA对梅毒检验的灵敏度和特异度较高,但是不能反映病情的变化情况;TRUST检测虽然灵敏度和特异度较低,但是其结果能随病情变化而变化,可以用作疾病治疗和预后的观察指标。因此在临床应用过程中应当将两种检查方法结合应用,在提高检查的准确性的同时也能够指导临床治疗,成为判断患者预后的依据。

Objective To compare the diagnostic value of Enzyme-linked Immunosorbent Assay（ELISA） and Toluidine Red Un-heated Serum Test（TRUST） in the diagnosis of syphilis. Methods 1 500 suspected cases of syphilis in our hospital from January 2015 to December 2016 were randomly selected for clinical study. All patients were received three tests including TPPA,ELISA and TRUST for syphilis positive detection. The results of TPPA test were taken as the gold standard to estimate sensitivity,specificity, positive predictive value, negative predictive value of ELISA and TRUST. Results In 1 500 suspected cases, a total of 1 093 cases was diagnosed as syphilis and 407 cases were excluded. Sensitivity,specificity,positive predictive value and negative predictive value of ELISA were 98. 08% , 96. 07% , 98. 53 % , and 94. 09 % respectively. The values of TRUST were 92. 04% , 87. 2 2% , 95. 08% and 80. 32% respectively. The values of ELISA method were higher than those of TRUST, and the difference was statistically signifi-cant （P〈0. 05）. Conclusion Sensitivity and specificity of ELISA method for syphilis test is relatively high,but the results can^ re-flect the changes of the disease. Although sensitivity and specificity of TRUST assay is low,but the results can vary with changes of patients＇ condition,so they can be used as observation index for disease treatment and prognosis. Therefore,in the process of clinical application, two methods can be used together to improve the accuracy of the tests and guide the clinical treatment, which can also provide a basis for the prognosis.