3种梅毒诊断实验对梅毒患者的临床诊断效果对比  

Comparison of the Effect of Three Diagnosis Experiment Methods in Patients with Syphilis

作　　者：夏卫[1,2] 王瑞东[3] 倪唯益 王庆[1] 黄吉利[1] 

机构地区：[1]上海市静安区石门二路社区卫生服务中心检验科,上海200041 [2]上海中医药大学附属曙光医院检验科,上海200021 [3]同济大学附属上海市肺科医院检验科,上海200320

出　　处：《现代生物医学进展》2015年第23期4532-4533,4540,共3页Progress in Modern Biomedicine

基　　金：上海市卫生局科研项目(WJD2009168)

摘　　要：目的:对比TPPA(梅毒螺旋体明胶颗粒凝集实验)、RPR(快速血浆反应测定)和USR(不加热血清反应素实验)对不同临床分期梅毒患者的临床诊断效果。方法:回顾性分析疑似梅毒病患共113人,其中被确诊为梅毒的99人,其余14人正常。对113人均采用RPR和USR初筛实验和TPPA梅毒确诊实验。评价RPR、USR、TPPA三种诊断的敏感性、特异性、阳性预测值和阴性预测值。结果:RPR和USR对梅毒诊断的敏感性、特异性、阳性预测值和阴性预测值差异无统计学意义(P>0.05)。TPPA各项值均高于RPR和USR,差异有统计学意义(P均<0.05)。RPR、USR对Ⅰ、Ⅱ和Ⅲ期梅毒确诊率无统计学差异(P>0.05),但TPPA对Ⅰ、Ⅱ期梅毒确诊率基本为100%,但是对Ⅲ期梅毒的确诊率降低,且差异有统计学意义(P<0.05)。结论:USR和RPR对临床梅毒均存在一定的误诊率,为提高临床疑似病例确诊率,应联合梅毒检测,TPPA虽为确诊实验,但对Ⅲ期梅毒仍有一定的漏诊率。Objective： To compare the diagnosis effect of the TPPA（treponema pallidum gelatin particle agglutination test）, RPR（rapid determination of plasma reaction） and USR（unheated serum reagin test） in patients with different clinical stages of syphilis.Methods： A total of 113 people with suspected of syphilis patients were retrospectively analyzed, of whom 99 were diagnosed with syphilis and the remaining 14 were normal. All the 113 persons adopted RPR, USR and TPPA diagnosis experiment. RPR, USR and TPPA diagnostic sensitivity, specificity, positive predictive value and negative predictive value were evaluated. Results： The diagnosis sensitivity, specificity, positive predictive value and negative predictive value of RPR and USR had no statistical significance（P〉0.05）.Each value of TPPA was higher than that of RPR and USR, and the difference was statistically significant（P〈0.05）. RPR, USR in SyphilisⅠ, Ⅱ and Ⅲdiagnosis rate had no statistical difference（P〉0.05）. But the TPPA in Syphilis I and II diagnosis rate was 100%. ForⅢ syphilis diagnosis, its rate was reduced, and the difference was statistically significant（P〈0.05）. Conclusion： USR and RPR have certain misdiagnosis rate for syphilis at different clinical stages, and in order to increase the rate of clinical suspected diagnosis, they should be jointed in syphilis detection. TPPA is confirmed experiment, but there is still some missed diagnosis for Syphilis III.

关 键 词：TPPA USR RPR 梅毒 临床诊断 

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