梅毒非特异性抗体与特异性抗体血清学检测的临床应用评价  

Clinical evaluation of serological detection of nonspecific antibody and specific antibody to syphilis

作　　者：赵英 徐红星[1] ZHAO Ying;XU Hong-xing(Department of Laboratory Medicine,the Affiliated Suzhou Municipal Hospital of Nanjing Medical University,Suzhou 215006,China)

机构地区：[1]苏州市立医院医学检验科,215006

出　　处：《实用皮肤病学杂志》2021年第4期211-213,共3页Journal of Practical Dermatology

摘　　要：目的评价梅毒血清学检测中非特异性抗体的甲苯胺红未加热血清试验(TRUST)和特异性抗体的梅毒螺旋体抗体酶联免疫吸附试验(TP-ELISA)、梅毒螺旋体颗粒凝集试验(TPPA)3种方法对梅毒诊断的临床应用。方法对340份血清样本分别采用上述3种方法进行梅毒抗体检测,以TPPA为对照,比较TRUST、TP-ELISA对梅毒诊断指标的灵敏度、特异性、符合率等,同时分析TP-ELISA的S/CO值与TPPA的一致性。结果 TRUST、TP-ELISA和TPPA阳性率分别为54.7%、83.5%和75.0%,与TPPA法比较差异均有统计学意义(P=0.000,P=0.006)。TRUST、TP-ELISA灵敏度和特异性分别为69.4%、99.2%和89.4%、63.5%。TP-ELISA法阳性标本S/CO值结果与TPPA阳性结果的符合率随S/CO值的下降而降低。结论 TP-ELISA法敏感性高于TRUST,梅毒抗体需联合检测以防误诊、漏诊。Objective To evaluate the clinical application of toluidine red unheated serum test(TRUST) for non-specific antibody, treponema pallidum antibody enzyme-linked immunosorbent assay(TP-ELISA) for specific antibodies and treponema pallidum particle agglutination test(TPPA) in syphilis diagnosis. Methods A total of 340 serum specimens from suspected syphilis patients were tested for syphilis antibody by the above three methods. Taking TPPA as the control, the sensitivity, specificity and coincidence rate of TRUST and TPELISA for syphilis diagnosis were compared, and the consistency between the sample-to-cutoff ratio(S/CO) value of TP-ELISA and TPPA results was analyzed. Results The positive rates of TRUST and TP-ELISA were 54.7%, 83.5% respectively, compared with TPPA(75.0%), the differences both had statistical significance(P=0.000, P=0.006). The sensitivity and specificity of TRUST and TP-ELISA were 69.4%, 99.2%, 89.4% and 63.5%, respectively. The coincidence rate between S/CO value of TP-ELISA positive samples and TPPA positive results reduced along with the decrease of S/CO value. Conclusion The sensitivity of TP-ELISA was higher than that of the TRUST, and the methods should be used jointly in detecting the treponema pallidum antibody in order to avoid misdiagnosis and missed diagnosis.

关 键 词：梅毒 抗体 TRUST 抗体 TPPA TP-ELISA 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]