不同方法检测少数民族人群梅毒感染结果分析  

Analysis on Results of Syphilis Infection Detected by Diverse Methods in Minority Population

作　　者：胡俊忠[1] 杨桂花 刘文杰[1] 

机构地区：[1]湖南省桑植县疾病预防控制中心,湖南桑植427100 [2]张家界市人民医院

出　　处：《实用预防医学》2012年第3期440-442,共3页Practical Preventive Medicine

摘　　要：目的探讨梅毒血清各种检测方法对梅毒的确诊及其治疗的灵敏性和特异性的临床指导意义。方法标本分别采用酶联免疫吸附试验、快速血清反应素环状卡片试验、荧光螺旋体抗体吸收试验、梅毒螺旋体血球凝集试验四种方法检测,并对结果进行比较分析。结果 ELISA、RPR、FTA-ABS、TPHA的敏感性分别为99.2%、98.3%、99.9%、91.3%,特异性为99.6%、86.4%、99.2%、94.2%。RPR与ELISA、FTA-ABS与TPHA2种方法检测结果经检验,差异无统计学意义(P>0.05),但RPR、ELISA与FTA-ABS、TPHA组间检测结果两两经检验,差异有统计学意义(P<0.05),且ELISA法的灵敏性和特异性均较好。在特异性方面,FTA-ABS法与ELISA、RPR、TPHA相比,差异有统计学意义(P<0.05),ELISA、RPR、TPHA两两间差异无统计学意义(P>0.05)。结论与FTA-ABS法的确认结果进行比较,RPR法不但有假阳性也有假阴性,存在梅毒漏检的可能;而ELISA法仅有假阳性、却无假阴性;ELISA法检出梅毒的能力强于RPR法。ELISA法是梅毒螺旋体血清学诊断试验的首选方法。近年来,ELISA法的应用研究主要趋向于联合使用两种或两种以上的重组梅毒螺旋体抗原,综合两种或多种抗原的不同特性,从而使ELISA法具有更高的特异性和敏感性。Objective To explore the clinical value of the results of syphilis tests with different serum screening methods in guiding syphilis diagnosis and sensitivity and specificity of treatment. Methods The specimens were determined by ELISA test,rapid plasma regain circle card test（RPR test）,fluorescent treponemal antibody-absorption test（FTA-ABS）,and Treponema pallidum hemagglutination assay（TPHA）,respectively,and the detection results were compared and analyzed. Results The sensitivities of ELISA,RPR test,FTA-ABS,and TPHA were 99.2%,98.3%,99.9%,and 91.3%,respectively.The specificities of ELISA,RPR test,FTA-ABS,and TPHA were 99.6%,86.4%,99.2%,and 94.2%,respectively.No statistically significant difference was found in the detection results between RPR test and ELISA,and between FTA-ABS and TPHA（P0.05）,but there were statistically significant differences in the detection results between RPR test,ELISA and FTA-ABS,TPHA（P0.05）,and moreover,the sensitivity and specificity of ELISE were both well.There were statistically significant differences in the specificity between FTA-ABS and ELISA,RPR test,TPHA（P0.05）,but no statistically significant difference was found in the specificity among ELISE,RPR test,TPHA（P0.05）. Conclusions Compared with FTA-ABS,the results of RPR test show not only false-positives but also false-negatives,which indicate that the cases of syphilis may be undetected or misdiagnosed.The results of ELISA show only false-positives,and the syphilis detection probability of ELISA is superior to that of RPR test.ELISA should be used as the first choice in serodiagnostic testing for Treponema pallidum infection.In recent years,application researches of ELISA mostly tend to use a combination of two or more than two Treponema pallidum recombinant antigens and to synthesize the different characteristics of two-or multi-antigen so as to make ELISE has a higher sensitivity and specificity.

关 键 词：梅毒 ELISA RPR FTA-ABS TPHA 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]