TPPA结合RPR方法对图木舒克市手术患者进行梅毒确诊及疗效观察的研究

TPPA Combined with RPR Method Was Used to Diagnose Syphilis and Observe its Curative Effect in Tumushuk City

目的:分析图木舒克市手术患者采取梅毒螺旋体抗体明胶颗粒凝集实验(TPPA)结合快速梅毒螺旋体抗体胶体金实验(金标法)方法确诊梅毒情况及疗效观察。方法:回顾性分析新疆图木舒克市人民医院收治的3000例术前患者血清,研究时段在2016年8月—2019年10月,收治的受检者是梅毒患者1300例,非梅毒患者1000例,健康体检者700例,均给予TPPA与金标法检测,若两种检测方法出现不相符的结果,则存留血清,通过免疫印迹法(WB)进行最后确诊,采用快速血浆反应素环状卡片试验(RPR)进行疗效观察。结果:1300名梅毒患者中,共检测出1300名TPPA阳性人数,阳性率为100.00%,1250名金标法阳性人数,阳性率为96.15%;1000名非梅毒患者中,未检测出TPPA阳性人数,阳性率为0.00%,15名金标法阳性人数,阳性率为1.50%;70名健康体检者中,均为阴性的金标法和TPPA结果。梅毒患者与非梅毒、健康体检者检测结果相比,组间差异明显(P<0.05);TPPA检查方法检测的灵敏度、特异度及正确指数均高于金标法检测方法,差异有统计学意义(P<0.05)。结论:TPPA法是给予图木舒克市手术患者梅毒确诊的有效方法,比金标法假阳性更少,采用TPPA法确诊梅毒并结合RPR做滴度检测观察疗效切实可行,填补了图市实验室确诊梅毒的空白,将会产生良好的社会效益。

Objective:To analyze the diagnosis of syphilis and observe the curative effect of treponema pallidum antibody gelatin pellet agglutination test(TPPA)combined with rapid treponema pallidum antibody colloidal gold test(gold standard method)in Tumushuk city.Methods:Serum samples of 3000 patients admitted to Tumushuke People's Hospital of Xinjiang before operation were retrospectively analyzed.The study period was from August 2016 to October 2019.There were 1300 syphilis patients,1000 non-syphilis patients and 700 healthy physical examination subjects,all of whom received TPPA and gold standard detection.If the two methods showed inconsistent results,the serum was saved and confirmed by western blotting(WB),and the curative effect was observed by rapid plasma rereaction ring card test(RPR).Results:Among 1300 syphilis patients,1300 were positive for TPPA,the positive rate was 100.00%,and 1250 were positive for gold standard method,the positive rate was 96.15%.Among 1000 non-syphilis patients,there were no TPPA positive patients,the positive rate was 0.00%,and there were 15 gold standard positive patients,the positive rate was 1.50%.All 70 healthy subjects had negative gold standard and TPPA results.The results of syphilis patients were significantly different from those of non-syphilis and healthy subjects(P<0.05).The sensitivity,specificity and accuracy index of TPPA were higher than those of gold standard method,and the difference was statistically significant(P<0.05).Conclusion:TPPA method is an effective method to diagnose syphilis in tumushuk surgical patients,with fewer false positives than gold standard method.It is feasible to use TPPA method to diagnose syphilis combined with RPR titer test to observe the curative effect,filling the blank of laboratory diagnosis of syphilis in Tumushuk city,and will produce good social benefits.