梅毒临床诊断的3种检测方法的应用评价  

Evaluation of three kinds of methods for clinical diagnosis of Treponema pallidum

作　　者：王靖[1] 王丽[2] 王春风[3] 

机构地区：[1]杭州师范大学医药卫生管理学院,浙江杭州310036 [2]浙江省血液中心,浙江杭州310006 [3]浙江大学医学院附属第一医院,浙江杭州310003

出　　处：《临床和实验医学杂志》2008年第3期19-20,共2页Journal of Clinical and Experimental Medicine

基　　金：杭州师范大学医药卫生管理学院科研基金资助(2007YZKJ10);杭州师范大学科研基金资助(杭师大教[2007]77号)

摘　　要：目的评价酶联免疫吸附试验(ELISA)、快速血浆反应素试验(RPR)和梅毒螺旋体明胶颗粒凝集试验(TP-PA)对梅毒病人诊断的敏感性和特异性。方法同时用ELISA、RPR和TPPA试剂对4 825例住院及门诊病人血清进行检测,TPPA试验作为确认试验,从而得出其他两种方法的敏感性和特异性。结果ELISA法的阳性率95.06%(385/405),假阳性率0.66%(29/4 420);RPR法阳性率70.12%(284/405),假阳性率0.45%(20/4 420);2种方法即ELISA、RPR法均阳性为275例,检出率为67.90%(275/405),假阳性率为0.11(5/4 420)。结论ELISA法是一种高敏感性的梅毒血清学诊断检测方法,ELISA与TPPA相关性良好,可作为确证试验。RPR只能作为辅助试验,如果3种方法结合使用,可使假阳性率下降。Objective To evaluate the sensitivity and specificity of enzyme linked immunosorbent assay （ELISA）, treponema pallidum particle agglutination assay （TPPA） and rapid plasma reagin test （RPR） in clinical diagnosis of treponemal infection. Methods Sera from 4825 syphilis patients were detected by ELISA, TPPA and RPR. The results obtained with ELISA and RPR were compared with those ob- tained with TPPA. The positive and false positive rates of different methods were calculated. Results The positive rate detected by ELISA and RPR and the method of superposition of TPPA and RPR were 95.06% （385/405） ,70.12% （ 284/405 ） and 67.90 % （ 275/405 ） respectively. The false positive rate of the above three methods were 0.66% （29/4 420 ） , 0.45 % （20/4 420 ） and 0.11 （ 5/4 420 ） respectively. Conclusion ELISA is a highly sensitive and specific serological method and can be used as confirmatory test for the diagnosis of treponemal infection. The result of ELISA and TPPA is well correlated. RPR can only be used as supplementary test. Combined analysis of the results of the three methods will decrease the false positive rate.

关 键 词：梅毒螺旋体明胶颗粒凝集试验(TPPA) 酶联免疫吸附试验(ELISA) 血浆反应素试验(RPR) 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]