甲苯胺红不加热血清试验在潜伏梅毒诊断中的应用价值评价  

Evaluation of Application Value on TRUST for Diagnosing Latent Syphilis

作　　者：杨寿旺 黄建可 李睿 吴昊[2] 周振达 徐建设 

机构地区：[1]温州国际旅行卫生保健中心,温州325000 [2]温州市第二人民医院,温州325000

出　　处：《中国国境卫生检疫杂志》2008年第6期379-381,共3页Chinese Journal of Frontier Health and Quarantine

基　　金：浙江出入境检验检疫局科研基金项目(ZK200734)

摘　　要：〔目的〕科学地评估甲苯胺红不加热血清试验(TRUST)在潜伏梅毒诊断中的应用价值。〔方法〕对165份梅毒螺旋体明胶凝集试验(TPPA)阳性血清进行TRUST试验、TP-IgM抗体的检测,并对患者进行病史和治疗情况的调查和随访。〔结果〕64名血清TPPA试验阳性、TRUST试验阴性者,其血清TP-IgM抗体全部为阴性。其中有26人来随访,未发现其有任何临床症状和体征,其血清TRUST试验和TP-IgM抗体均仍为阴性;19名血清TPPA试验阳性、TRUST为可疑反应者,只有1份血清TP-IgM抗体为阳性。其中有11人来随访,其血清TRUST试验有4份转为阴性,TP-IgM抗体(包括1份原TP-IgM抗体为阳性者)全部为阴性,也未发现其有任何临床症状和体征;在82名血清TPPA试验阳性、TRUST也阳性者中,TRUST试验滴度在1:4以下者,TP-IgM抗体阳性极少。有43名接受正规治疗后,随访虽也未发现任何临床症状和体征,但只有9名血清TRUST试验转为可疑反应或阴性。〔结论〕TRUST试验的阴性结果是可靠的;在梅毒患者接受治疗前,TRUST试验的阳性结果(排除生物学假阳性)也是可靠的;但在接受正规治疗后,TRUST试验的阳性结果已难以反映实际病情。Objective To evaluat the application value of TRUST for diagnosing latent syphilis. Method 165 serums of TPPA positive were tested by using TRUST and TP-IgM anitibodies,and both the case history and therapy status were investigated.Follow-up was then carried out. Result TP-IgM anitibodies were all negative among the serums of the 64 personnel of which TPPA was positive and TRUST was negative.No clinical symptoms or signs were found among the 26 personnel who came to accept follow-up, the TRUST and the TP-IgM anitibodies were all negative as well; Only one of the TP-IgM anitibodies was positive among the serums of the 19 personnel of which TPPA was positive and TRUST was a borderline reaction.Four of the TRUST changed to negative and the TP-lgM anitibodies （including tbe one of which TP-IgM anitibody was originally positive） all were negative among the 11 personnel who came for a follow-up,No clinical symptoms or signs were found either;TP-IgM anitibodies few were positive when the TRUST titers were under 1：4 among the serums of the 82 personnel of which TPPA and TRUST were all positive.Though no clinical symptoms or signs were found,but only nine of the TRUST changed to either a borderline reaction or negative among the serums of the 43 personnel of whieb TPPA was positive and TRUST was positive after they had accepted standard treatment. Conclusion The negative results of TRUST are reliable;The positive results of TRUST（getting rid of the false positive of biology） are trustworthy before the patients with syphilis accepted treatment,But the positive results of TRUST cann＇t reflect reality state of Syphilis after they have accepted standard treatment.

关 键 词：梅毒 潜伏 血清诊断 应用价值 评价 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]