梅毒螺旋体明胶颗粒凝集试验临床应用再评价  

Re-evaluation of treponema pallidum particle assay in the detection of syphilis

作　　者：文爱清[1] 孙继德[2] 黄衡柳[2] 袁玲[1] 何静[1] 陈方祥[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所输血科,重庆400042 [2]第三军医大学大坪医院野战外科研究所检验科,重庆400042

出　　处：《重庆医学》2010年第3期298-299,301,共3页Chongqing medicine

摘　　要：目的评价梅毒螺旋体明胶颗粒凝集试验(TPPA)法在血清梅毒抗体检测中的应用价值。方法(1)分别收集临床确诊梅毒患者89例和非梅毒患者135例血清标本,分别用TPPA法和荧光密螺旋体抗体吸收试验(FTA-ABS)法进行梅毒抗体检测,以FTA-ABS法为金标准,评价TPPA法的敏感性和特异性;(2)将非梅毒患者分为老年组(≥60岁)65例和非老年组(<60岁)70例,比较不同年龄组TPPA法假阳性率。结果(1)TPPA法检测确诊梅毒的敏感性、特异性、阳性预测值和阴性预测值分别为94.4%、91.1%、87.5%、96.1%,与FTA-ABS法比较差异无统计学意义(P>0.05);(2)TPPA法在老年组的假阳性率为15.38%,高于非老年组(2.86%),也高于FTA-ABS法(老年组为4.62%,非老年组为1.43%)。结论TPPA法在临床梅毒血清学确认检测中应结合FTA-ABS法加以确证,以提高梅毒诊断的准确性。Objective To re-evaluate the clinical value of the treponema pallidum particle assay（TPPA）in the detection of syphilis IgG antibody.Methods（1）Eighty-nine patients with clinical definite syphilis and 135 cases of non-syphilis,were enrolled in our study.Methods of TPPA and fluorescent treponemal antibody absorption test（FTA-ABS）were used for serological assays of the detection of syphilis IgG antibody.The sensitivity and specificity of the methods were compared by Chi-square test.（2）Non-syphilis patients were divided into elderly group（≥60years old,n=65）and non-elderly group（〈60years old,n=70）,and the false positive rate was compared between the two sub-group.Results（1）The sensitivity,the specificity,the positive predictive value and the negative predictive value of TPPA were 94.4%,91.1%,87.5% and 96.1%,respectively,not significantly different compared with those of FTA-ABS（P〉0.05）.（2）The false positive rate of TPPA in elderly group was 15.38%,higher than that in the non-elderly group（2.86%）.And the difference between the two sub-groups was higher than that of FTA-ABS（4.62% vs 1.43%）.Conclusion In the detection of syphilis IgG antibody,TPPA may combined with FTA-ABS to improve its specificity.

关 键 词：FTA-ABS TPPA 梅毒 血清学诊断 方法学比较 

分 类 号：R759.1[医药卫生—皮肤病学与性病学] R446.112[医药卫生—临床医学]