脑脊液ECLIA与FTA-ABS检测在NS诊断中的应用价值研究  

Study on the application value of cerebrospinal fluid ECLIA and FTA-ABS in the diagnosis of NS

作　　者：应姗珊 罗岚[1] 邓杰伦 王远芳[1] 李冬冬[1] YING Shanshan;LUO Lan;DENG Jielun;WANG Yuanfang;LI Dongdong(Department of Laboratory Medicine,West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院实验医学科,四川成都610041

出　　处：《国际检验医学杂志》2021年第11期1291-1294,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨脑脊液(CSF)梅毒特异性抗体在神经梅毒(NS)诊断中的应用价值。方法选择2018年1月至2020年1月于该院确诊的梅毒患者124例作为研究对象,以梅毒性病研究实验室试验(VDRL)结果作为诊断NS金标准,将患者分为NS组(36例)和非NS组(88例),收集患者相关临床资料,评价电化学发光免疫分析(ECLIA)和荧光螺旋体抗体吸收试验(FTA-ABS)对NS的诊断效能。结果ECLIA检测CSF梅毒特异性总抗体诊断NS的最佳临界值为19.1,AUC为0.964(95%CI:0.914~0.989),灵敏度为92.05%,特异度为94.44%;FTA-ABS检测CSF免疫球蛋白G(IgG)诊断NS的AUC为0.878(95%CI:0.810~0.930),灵敏度为97.22%,特异度为78.41%;FTA-ABS检测CSF免疫球蛋白M(IgM)诊断NS的AUC为0.650(95%CI:0.560~0.730),灵敏度为30.56%,特异度为98.86%。结论FTA-ABS检测CSF IgG诊断NS的灵敏度最高,但其操作复杂,可考虑作为NS的阴性排除试验;FTA-ABS检测CSF IgM诊断NS的灵敏度低但特异度较高,可以考虑作为NS活动感染指标;ECLIA检测CSF anti-TP诊断NS的灵敏度和特异度较好,而且操作简便及自动化程度高,可考虑作为筛查试验。Objective To investigate the value of cerebrospinal fluid(CSF)syphilis specific antibody in the diagnosis of neurosyphilis(NS).Methods A total of 124 syphilis patients diagnosed in the hospital from January 2018 to January 2020 were selected as the research objects,and the results of syphilis and venereal disease research laboratory test(VDRL)were used as the gold standard for NS diagnosis,the patients were divided into the NS group(36 cases)and the non-NS group(88 cases).The clinical data of patients were collected totally,and the diagnostic efficacy of electrochemiluminescence immunoassay(ECLIA)and fluorescent treponemal antibody absorption test(FTA-ABS)for NS.Results The best cut-off value of ECLIA for detecting CSF syphilis-specific total antibodies for diagnosing NS was 19.1,AUC was 0.964(95%CI:0.914-0.989),the sensitivity was 92.05%,and the specificity was 94.44%;The AUC of FTA-ABS for the detection of CSF immunoglobulin G(IgG)in the diagnosis of NS was 0.878(95%CI:0.810-0.930),the sensitivity was 97.22%,and the specificity was 78.41%;The AUC of FTA-ABS in detecting CSF immunoglobulin M(IgM)in the diagnosis of NS was 0.650(95%CI:0.560-0.730),the sensitivity was 30.56%,and the specificity was 98.86%.Conclusion FTA-ABS has the highest sensitivity for detecting CSF IgG in diagnosing NS,but its operation is complicated and can be considered as a negative exclusion test for NS;FTA-ABS has low sensitivity but high specificity for detecting CSF IgM in diagnosing NS,and can be considered as active NS infection Indicators:ECLIA has good sensitivity and specificity for detecting CSF anti-TP in diagnosing NS,and it is easy to operate and has a high degree of automation.It can be considered as a screening experiment.

关 键 词：神经梅毒 梅毒特异性抗体 脑脊液 

分 类 号：R759.13[医药卫生—皮肤病学与性病学]