三种方法学检测不同标本在梅毒患者诊疗中的价值

The value of three methods for detecting different specimens in the diagnosis and treatment of syphilis patients

目的比较分析三种梅毒检测方法的效果及阳性率,为梅毒患者诊断与治疗提供依据。方法选取2018年3月至2018年8月万宁市人民医院诊治的308例住院和门诊梅毒患者作为研究对象。同时采用TPPA、TRUST、TP-ELISA方法进行梅毒血清学检测,比较三种方法的梅毒阳性率、灵敏度、准确度及最低检测浓度。结果TPPA法与TP-ELISA法检测梅毒阳性率分别为26.62%、26.30%;TRUST法检测梅毒阳性率为16.88%,低于TPPA法,差异具有统计学意义(P<0.05);TRUST法检测灵敏度、准确度分别为59.76%、88.31%,均低于TPPA法,差异均具有统计学意义(均P<0.05);TRUST法所需最低检测浓度高于其他两种方法,差异具有统计学意义(P<0.05);梅毒患者治疗前后TRUST滴度水平、阳性率均明显下降,差异具有统计学意义(P<0.05)。结论TPPA法、TP-ELISA法检测梅毒阳性率、灵敏性、准确度高,所需最低检测浓度低,可用于大量梅毒样本的筛查、诊断;TRUST法可作为患者临床疗效辅助观察指标。

Objective To compare and analyze the three methods for syphilis detection,so as to provide evidence for the diagnosis and treatment of syphilis.Methods A total of 308 inpatients and outpatients with syphilis admitted to Wanning People′s Hospital from March 2018 to August 2018 were selected.TPPA,TRUST and TP-ELISA methods were used for serological detection of syphilis,and the positive rate,sensitivity,accuracy and minimum detection concentration of syphilis were compared among the three methods.Results The positive rates of TPPA and TP-ELISA were 26.62%and 26.30%,respectively.The positive rate of TRUST was 16.88%,lower than that by TPPA,with statistically significant difference(P<0.05).The sensitivity and accuracy of TRUST method were 59.76%and 88.31%,respectively,which were lower than TPPA method,with statistically significant difference(all P<0.05).The minimum detection concentration required by TRUST method is higher than that of the other two methods,with statistically significant difference(P<0.05).The TRUST titer and positive rate of syphilis patients decreased significantly before and after treatment,with statistically significant difference(P<0.05).Conclusions TPPA and TP-ELISA can be used for screening and diagnosis of a large number of syphilis samples with high positive rate,sensitivity,high accuracy and low minimum detection concentration.TRUST method can be used as an auxiliary observation index of clinical efficacy.