CLIA、ELISA、TRUST诊断梅毒螺旋体抗体的价值分析

Analysis of the value of CLIA,ELISA and trust in the diagnosis of Treponema pallidum antibody

目的分别探讨化学发光免疫分析法(CLIA)及酶联免疫吸附试验(ELISA)及甲苯胺红不加热血清试验(TRUST)在梅毒螺旋体抗体中的临床检测价值。方法回顾性分析2018年7月-2019年7月期间在九江市濂溪区人民医院就诊的130例疑似梅毒感染患者的临床资料,所有入选者均需通过苍白密螺旋体明胶颗粒凝集试验(TPPA)、CLIA、ELISA以及TRUST对其血清标本内梅毒螺旋体抗体给予检测,并以TPPA检测结果为金标准,分析不同检测方法检测结果与诊断效能。结果将TPPA检测结果视作金标准,CLIA的诊断梅毒抗体的准确度为98.46%(128/130),ELISA为96.92%(126/130),TRUST为85.38%(111/130)。CLIA、ELISA与TPPA的诊断准确率对比,差异无统计学意义(P>0.05);TRUST诊断准确率低于TPPA诊断结果,差异有统计学意义(P<0.05);CLIA、ELISA诊断敏感度、特异度、阳性预测值、阴性预测值均高于TRUST诊断结果,差异有统计学意义(P<0.05)。结论在梅毒螺旋体抗体检测方面,CLIA与ELISA法均具有良好的诊断效能,TRUST诊断效果相对较差,临床应依据患者实际情况以及检测目的,结合患者临床症状、病史等,采取对应检测方法,以进一步作出有效综合诊断结果。

Objective To explore the clinical value of chemiluminescence immunoassay(CLIA),enzyme-linked immunosorbent assay(ELISA)and toluidine red unheated serum test(TRUST)in detection of Treponema pallidum antibodies.Methods The clinical data of 130 suspected syphilis patients treated in our hospital from July 2018 to July 2019 were retrospectively analyzed.All the selected patients were required to pass Treponema pallidum gelatin agglutination test(TPPA),CLIA,ELISA and TRUST to detect Treponema pallidum in their serum samples.The results of TPPA were used as gold standard to analyze the detection results and diagnostic efficiency of different detection methods.Results The accuracy of TPPA was 98.46%(128/130)for CLIA,96.92%(126/130)for ELISA and 85.38%(111/130)for TRUST.There was no significant difference between TPPA and CLIA and ELISA(P>0.05).The accuracy of TRUST was lower than that of TPPA(P>0.05).The diagnostic sensitivity,specificity,positive predictive value and negative predictive value of CLIA and ELISA were higher than those of TRUST(P<0.05).Conclusion In the detection of Treponema pallidum antibody,CLIA and ELISA have good diagnostic efficacy.Trust has a relatively poor diagnostic effect,according to the actual situation of patients and the purpose of detection,combined with the clinical symptoms and medical history of patients,corresponding detection methods should be adopted to further make effective comprehensive diagnosis results.