明胶颗粒凝集试验联合ELISA法在梅毒检测中的应用价值

Application of gelatin granule agglutination test combined with ELISA in the detection of syphilis

目的分析明胶颗粒凝集试验(TPPA)联合酶联免疫吸附试验(ELISA)在梅毒检测中的应用价值。方法选择我院2015年1月至2018年12月收治的128例疑似梅毒患者为研究对象,将其中43例临床确诊患者纳入梅毒组,余下85例为非梅毒组,全部受试者均接受ELISA法联合TPPA检测,比较单独ELISA法和ELISA联合TPPA检测的结果。结果梅毒组患者中ELISA法诊断阳性35例,阴性8例;ELISA联合TPPA诊断阳性42例,阴性1例;ELISA法假阳性率14.63%(6/41),明显高于ELISA联合TPPA法的2.33%(1/43),差异有统计学意义(χ^2=4.163,P=0.041)。ELISA联合TPPA诊断梅毒的特异性、敏感性、阴性预测值及阳性预测值分别为98.82%、97.67%、98.82%、97.67%,均显著高于单独ELISA检测的92.94%、81.40%、90.80%、85.37%,差异均有统计学意义(χ^2=143.650、6.081、5.575、4.163,P<0.001、=0.014、=0.018、=0.041)。结论ELISA适用于大批量梅毒筛查,TPPA法的特异性及敏感性高,可作为梅毒血清抗体检测的确认试验。二者联合检测能够提高梅毒诊断效能,具有较高的应用价值。

Objective To analyze the application value of gelatin granule agglutination test(TPPA)combined with Enzyme-linked immunosorbent assay(ELISA)in the detection of syphilis.Methods A total of 128 patients with suspected syphilis who were treated in our hospital from January 2015 to December 2018 were included,among whom 43 patients were clinically diagnosed as syphilis group,with the remaining 85 patients as non-syphilis group.All the subjects received ELISA combined with TPPA test,and the results by ELISA and those by ELISA combined TPPA test were compared.Results Among the 43 cases of clinically confirmed syphilis,ELISA found 35 positive cases and 8 negative cases,While ELISA combined with TPPA found 42 positive cases and 1 negative case.The false positive rate of ELISA was 14.63%(6/41),higher than the 2.33%(1/43)of TPPA combined ELISA,with statistically significant difference(χ^2=4.163,P=0.041).The specificity,sensitivity,negative predictive value and positive predictive value of ELISA combined with TPPA in the diagnosis of syphilis were 98.82%,97.67%,98.82%and 97.67%respectively,significantly higher than the 92.94%,81.40%,90.80%and 85.37%by ELISA(χ^2=143.650,6.081,5.575,4.163;P<0.001,=0.014,=0.018,=0.041).Conclusion ELISA is suitable for syphilis screening in large populations.The specificity and sensitivity of TPPA method are high,which can be used confirm the result of syphilis serum antibody detection.The combined detection can improve the diagnostic efficiency of syphilis and has high application value.