TRUST试验在梅毒传染性中的诊断价值评估

TRUST test in the diagnosis of infectious syphilis value and clinical significance

目的 探讨甲苯胺红快速血浆反应素试验（TRUST）在梅毒传染性中的诊断价值和临床意义。 方法 收集酶联免疫吸附试验（ELISA）和梅毒螺旋体颗粒凝集试验（TPPA）试验均阳性的住院患者血清73例，再用TRUST试验和梅毒螺旋体IgM抗体蛋白印迹试验（TP-IgM）进行检测，采用SPSS 16.0软件建库统计指标计算与分析两种试验的结果。 结果 随着TRUST滴度的升高，TP-IgM的阳性率也升高，差异有统计学意义（H=7.267, P 〈0.05）。经两两比较，TRUST阴性与阳性组滴度〈1∶8的TP-IgM阴阳性没有统计学意义（H=0.141, P 〉0.05）；TRUST阴性与阳性组滴度≥1∶8的TP-IgM阴阳性有统计学意义（H=5.909, P 〈 0.05 ）；TRUST阳性组滴度〈1∶8与滴度≥1∶8的TP-IgM阴阳性有统计学意义（H=5.859, P 〈0.05）。TRUST、TP-IgM阴性组和阳性组（包括弱阳性、阳性和TRUST〈1∶8）一致性检验差（Kappa=0.011， P = 0.916 ），TRUST、TP-IgM阴性组（包括阴性、弱阳性和TRUST〈1∶8）和阳性组一致性检验差（Kappa= 0.006 ， P =0.951）。 结论 TRUST试验对梅毒传染性有较好的诊断价值，特别在滴度≥1∶8时，临床工作者更应该注意其传染性；对TRUST阴性和滴度〈1∶8时，TP-IgM是判断标本有无传染性的补充指标。

Objective： To toluidine red unheated-serum test（TRUST） in the diagnosis of infectious syphilis value and clinical significance. Methods To collect 73 serums which definite diagnosis was based on the results of enzyme linked immunosorbent assay（ELISA） and treponema pallidum particle agglutination（TPPA） assay,then use TRUST test and treponema pallidum serum IgM antibody Western blot test（TP-IgM） to detect,results were analyzed by SPSS 16.0 statistical software. Results： The positive rate of TP-IgM was increased with the titer of TRUST,which different have statistically significant（H= 7.267 , P 〈0.05）.After pairwise comparison,the positive rate of TP-IgM have no statistically significant between TRUST negative and positive group titer is less than 1∶8（H=0.141, P 〉0.05）;the positive rate of TP-IgM have statistically significant between TRUST negative and positive group titer is greater than or equal 1∶8（H=5.909, P 〈0.05）;the positive rate of TP-IgM have statistically significant between TRUST titer is less than 1∶8 group and greater than or equal 1∶8 group（H=5.859, P 〈0.05）.Consistency test of the Trust,the TP-IgM negative group and positive group（including weakly positive,positive and Trust 〈1∶8） poor（Kappa = 0.011, P =0.916）;Consistency test of the Trust,the TP-IgM negative group（including negative,weak positive and Trust 〈1∶8） group（Kappa = 0.006, P =0.951）. Conclusion： TRUST test have good diagnostic test for syphilis infectious,especially when the titer greater than or equal 1∶8,clinicians should pay more attention to its infectious.When trust negative and titer less than 8：00,the TP-IgM is to judge whether the specimen infectious additional indicators.