摘要
目的探讨在梅毒螺旋体(TP)感染的诊断中联合应用3种血清学检测方法的临床价值。方法用梅毒螺旋体抗体酶联免疫吸附试验(TP-ELISA)对临床标本进行梅毒筛查,阳性标本进一步行梅毒螺旋体明胶凝集试验(TPPA)和甲苯胺红不加热血清试验(TRUST)滴度检测。结果6483例血清标本行TP-ELISA筛查,检出阳性342例,其中TPPA法检测结果阳性313例,阳性检出率为91.5%(313/342);TRUST滴度在1∶2以上的265例,TPPA确证264例为阳性;TRUST滴度阴性77例,TPPA确证阳性49例,29例TP-ELISA阳性而TPPA阴性的标本TRUST滴度(<1∶2)阴性为28例。结论TP-ELISA法敏感性较高,操作方便,易自动化,可取代TRUST作为梅毒的常规筛查,但存在假阳性(8.2%)问题,尤其以60岁以上的老年人居多。TP-ELISA阳性的标本应进一步行TPPA确证,若TPPA阴性,2周后应再复查1次TPPA。TRUST已不适合梅毒的常规筛查,但其滴度可用于临床疗效观察。
Objective To explore the clinical value of combined application of three serological detective methods for the diagnosis of treponema pallidum（TP） infection.Methods All of 6 483 clinical specimens underwent routine TP antibody screening with enzyme linked immunosorbent assay（ELISA） method;positive samples were further tested by toluidine red unheated-serum test（TRUST） and treponema pallidum particle agglutination（TPPA）.Results Among 342 TP antibody screening positive specimens（TP-ELISA）,313 positive results were reseted by TPPA.The positive rate of TPPA was 91.5%（313/342）.Of 265 positive samples detected with TRUST titer,264 were positive by TPPA.Forty-nine out of 77 TRUST titer negative samples were positive by TPPA.Of 29 samples,which were positive results tested by TP-ELISA but were negative by TPPA,28 cases were lower than 1∶ 2（negative）.Conclusions TP-ELISA shows better sensibility,simple operation and easy automation,so it tends to displace TRUST as routine screening method,but it exists false positive（8.2% ）,especially for old people（≥60 years old） .TP-ELISA screening positive specimens should be further tested by TPPA;if TPPA negative,test it again after two weeks.TRUST is not suitable as a routine screening method,but TRUST titer may be used to observe therapeutic effect.
出处
《中国临床研究》
CAS
2010年第1期16-18,共3页
Chinese Journal of Clinical Research
