4种实验室检测方法对儿童梅毒的临床诊断价值分析  

Analysis on the results of four experimental detection methods for the diagnosis of syphilis in children

作　　者：宋贤响 田礼军 邹华新 

机构地区：[1]江苏省徐州市儿童医院检验科,江苏徐州221006 [2]江苏省徐州市儿童医院外科,江苏徐州221006

出　　处：《中国医药导报》2014年第5期89-92,共4页China Medical Herald

基　　金：江苏省徐州市社会发展科技计划项目(编号XEYKJ201204)

摘　　要：目的 对疑似梅毒儿童的临床检测数据进行回顾性研究分析,为儿童梅毒临床诊断提供充分全面的检测诊断信息,为临床治疗诊断提供依据.方法 选择徐州市儿童医院2010年4月～2012年12月门诊及住院141例0～3岁所有疑似梅毒儿童的血液标本进行分组,其中婴儿组（0～＜1岁）119例和幼儿组（1～3岁）22例;并且分别进行了以下检测：快速血浆反应素实验（RPR）、胶体金实验（SYP）、酶联免疫梅毒抗体检测（ELISA）、凝集法（TPPA）实验.所得数据进行SPSS 13.0统计软件分析.结果 用4种检测方法对血液标本进行梅毒抗体检测,ELISA阳性率（96.45％）最高,RPR阳性率（46.10％）最低;SYP法阳性率（77.30％）和TPPA法阳性率（85.11％）高于RPR法,差异有统计学意义（x2=53.36,P=0.000）;SYP和TPPA法阳性率低于ELISA阳性率,差异有统计学意义（x2=61.76,P=0.000）：ELISA假阳性最高（78例）,TPPA无假阳性,新生儿的假阳性明显高于幼儿组（P＜0.05）.结论 用ELISA方法对新生儿梅毒检测的假阳性率较高,大部分都是溶血引起.RPR方法在新生儿疑似梅毒中敏感性较低;SYP适合急诊;TPPA可以用作梅毒确诊实验;几种方法在儿童梅毒检测中要配合使用,综合判断,不要以一种检测方法的结果判断感染与否.初次检测小儿梅毒的阳性标本要经过一定时间定期复查然后确诊.Objective To analyze the clinical testing data of children suspected of syphilis, to provide more comprehen- sive information and the experimental basis for the clinical diagnosis of syphilis in children. Methods All blood sam-ples of 141 suspected syphilis 0-3 years old children in XuZhou Children＇s Hospital, from April 2010 to December 2012 were selected and divided into infants group （0-〈1 years old） with 119 cases and children group （1-3 years old） with 22 cases; experimental detection methods were used separately, the rapid plasma regain test （RPR）, the colloidal gold test （SYP）, the enzyme association immunity syphilis immune body examines （ELISA） and the agglutination test （TPPA）. The relevant experimental data were analyzed by SPSS 13.0. Results The positive rate of ELISA was the high- est, it was 96.45%, and RPR was the lowest, it was 46.10%; the positive rate of SYP （77.30%） and TPPA （85.11%） were higher than RPR （X2 = 53.36, P = 0.000）, the positive rate of SYP and TPPA were lower than ELISA （X2 = 61.76, P = 0.000）, the differences were statistically significant （P 〈 0.05）. Among the 86 false positive, false positive rate of ELISA was the highest （78 cases）, no false positive of TPPA was found. The false positive of the children group was higher than that of infant group （P 〈 0.05）. Conclusion The high false positive rate of ELISA is high, the reason is hemolysis. RPR is low sensitivity, and SYP is adapted to emergency treatment. But the TPPA is fit for the diagnosis of syphilis. The best way to the diagnosis of syphilis in children is two or two more methods used together, and making comprehen sive Judgment. It is necessary for the primary diaznosis of the syphilis in children to reexamine in the course of time.

关 键 词：儿童梅毒 血清学检测 新生儿梅毒 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]