4种不同梅毒抗体检测方法的临床应用及效果评价

Clinical Application and Evaluation of Four Different Syphilis Antibody Detection Methods

目的:探讨4种不同梅毒抗体检测方法的临床应用效果。方法:选取2016年10月至2017年10月在我院进行梅毒抗体检测者200例,分别应用甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体酶联免疫吸附试验(TP-ELISA)、梅毒胶体金试验(SYP)及梅毒螺旋体抗体明胶颗粒凝集试验(TPPA)检测研究对象血清标本中的梅毒抗体,经确诊梅毒患者80例,非梅毒患者120例,比较4种不同检测方法的准确度及敏感性和特异性的差异。结果:TRUST、TP-ELISA、SYP和TPPA 4种检测方法的准确度分别为83.50%、96.00%、98.50%和97.50%,敏感性分别为83.75%、96.25%、98.75%和97.50%,特异性分别为83.33%、95.83%、98.33%和97.50%,其中TP-ELISA、SYP和TPPA 3种方法之间的敏感性差异无统计学意义(P>0.05),且3种方法的敏感性均高于TRUST(P<0.05);4种方法的特异性比较差异均无统计学意义(P>0.05)。结论:梅毒患者可先采用TP-ELISA进行初筛,同时使用SYP对初筛阳性的标本进行检测比对,如果两种方法的结果不一致,可选择TPPA进一步确诊,而TRUST法则可以辅助检测,充分利用不同检查方法的优势,能更好地为临床梅毒诊断提供重要的参考依据。

Objective:To explore the clinical effect of 4 different syphilis antibody detection methods.Methods:A total of 200 cases of syphilis antibodies were tested in our hospital from Oct 2016 to Oct 2017.The serum samples were detected by toluidine red unheated serum test(TRUST),syphilis spiral enzyme-linked immunosorbent assay(TP-ELISA),syphilis colloid gold test(SYP)and Treponema pallidum anti-body gelatin particle agglutination test(TPPA).And 80 cases of syphilis and 120 cases of non syphilis were diagnosed.The accuracy,sensitivity and specificity of the 4 different methods were compared.Results:The accuracy of TRUST,TP-ELISA,SYP and TPPA were 83.50%,96.00%,98.50%and 97.50%respectively.The sensitivity was 83.75%,96.25%,98.75%and 97.50%respectively,and the specificity was 83.33%,95.83%,98.33%and 97.50%respectively.There was no significant differences in the sensitivity between TP-ELISA,SYP and TPPA(P>0.05),and the sensitivity of the 3 methods was higher than that of TRUST(P<0.05).The specificity of the 4 methods was very high,but the difference was not statistically significant(P>0.05).Conclusions:The patients with syphilis can be screened by TP-ELISA first,and SYP can be used to compare the initial screening test.If the results of the two methods are not consistent,the TPPA can be further confirmed,and the TRUST rule can be assisted to detect and make full use of the advantages of different methods to provide better diagnosis of clinical syphilis.