三种梅毒螺旋体血清学检验方法的临床应用分析  

Application analysis of three serological testing methods of treponema paelidum for clinical diagnosis

作　　者：肖霞[1] 滕春燕[1] 马慧 宋丹丹[1] 李艳蕾[1] 王欣[1] XIAO Xia;TENG Chun-yan;WANG Xin(Department of Clinical Laboratory,The Second Hospital of Jilin University,Jilin Changchun 130041,China)

机构地区：[1]吉林大学第二医院检验科,吉林长春130041

出　　处：《中国实验诊断学》2020年第2期286-289,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的针对3种梅毒螺旋体血清学检验方法在临床应用进行分析。方法患者标本首先进行梅毒螺旋体抗体酶联免疫吸附试验(TP-ELISA)检测,其中336例阳性患者再进行梅毒螺旋体明胶颗粒凝集实验(TPPA)、快速血浆反应素环状卡片实验(RPR)两种血清学检测。临床上明确诊断为梅毒的238例患者作为研究组,同期来我院就诊的150例健康体检者作为对照组,统计检测结果进行分析。结果随着TP-ELISA试验的S/CO值的升高,TPELISA与TPPA检测结果的符合率随之升高。TPPA敏感度与特异度分别为97.47%、99.16%;ELISA分别为98.32%、98.00%;RPR分别为78.57%、94.00%。RPR对于早期与潜伏期梅毒的实验室检测阳性检出率明显低于TPPA、ELISA(P<0.05),而三种方法对晚期梅毒实验室检测阳性检出率未见明显差异(P>0.05)。结论 TPPA与ELISA方法检验梅毒螺旋体敏感度和特异度均较好,是良好的血清学检测方法适用于筛查和确诊,RPR适用于判断梅毒疗效及观察病情进程。TPPA或ELISA联合RPR实验可作为各期梅毒检测的可靠方法。Objective To explore the clinical application value of three serological methods for Treponema pallidum.Methods All samples were tested by TP-ELISA titer.If TP-ELISA was positive,TPPA was used to confirm the TPELISA.Among them,336 positive patients were treated with gelatin particle agglutination(TPPA)and RPR two serological tests,238 syphilis patients in outpatient and inpatient treatment of Dermatology and Venereology Department of our hospital were taken as study group,150 non-syphilis patients in our hospital were taken as control group during the same period.All subjects were collected venous blood for three serological tests:enzyme-linked immunosorbent assay(ELISA),gelatin particle agglutination assay(TPPA),rapid plasma reactin assay(RPR).Results TPPA sensitivity and specificity were 97.47% and 99.16%,ELISA 98.32% and 98.00%,RPR 78.57% and 94.00%,respectively.The positive coincidence rate of ELISA and TPPA was 99.6%.The positive rate of RPR for primary,secondary and latent syphilis was significantly lower than that of TPPA and ELISA(P<0.05),but there was no significant difference among the three methods(P>0.05).Conclusion TPPA and ELISA are good serological diagnostic methods for Treponema pallidum.TRUST is suitable for judging the efficacy of syphilis and observing the course of the disease.TPPA or ELISA combined with RPR test can be used as a reliable method for syphilis screening in different stages.

关 键 词：梅毒螺旋体 酶联免疫吸附法(ELISA) 明胶颗粒凝集法(TPPA) 快速血浆反应素环状卡片实验(RPR) 敏感度 特异度 

分 类 号：R446.11[医药卫生—诊断学]