TP-ELISA、TRUST和TPPA联合检测在梅毒诊断中的应用

目的: 探讨梅毒螺旋体抗体酶联免疫吸附试验(TP-ELISA)、梅毒甲苯胺红不加热试验(TRUST)和梅毒螺旋体抗体明胶颗粒凝集试验(TPPA)在梅毒诊断中的价值。方法: 用TP-ELISA法对临床标本作梅毒筛查, 对筛查出的93例阳性标本和16例样本与临界质控吸光度比值(S/CO)在0.80～0.99范围内的灰区标本进一步做TRUST和TPPA检测。结果: TP-ELISA法检出的93例梅毒阳性标本, 经TPPA确证阳性83例, 弱阳性6例, 阳性符合率95.70%(89/93)。TP-ELISA 法检出的93例梅毒阳性标本中有32例TRUST阳性, 且TPPA确证试验均为阳性;而61例TRUST阴性标本中, TPPA确证阳性51例, 弱阳性6例, 阴性4例。16例S/CO值在0.80～0.99之间的灰区标本, 经TPPA确证1例为阳性, 1例为弱阳性。结论: 梅毒TP-ELISA法筛查存在一定的假阳性和假阴性。TP-ELISA阳性标本先以TRUST确证, 而对于TRUST阴性标本需进一步采用TPPA确证;对S/CO值在0.80～0.99之间的灰区标本也应用TPPA确证, 以减少梅毒的误诊和漏诊。

Applicable value of the combined detection of TP-ELISA,TRUST and TPPA in the diagnosis of syphilis

Objective:To explore the clinical significance of Treponema pallidum-enzyme linked immunosorbent assay(TP-ELISA), syphilis toluidine red untreated serum test ( TRUST ) and treponemapallidum particle agglutination assay ( TPPA ) in the diagnosis of syphilis. Methods:The syphilis in the clinical samples were screened by TP-ELISA,and the 93 positive specimens and 16 specimens with the 0. 80 to 0. 99 of S/CO value were further confirmed by TRUST and TPPA. Results:Among the 93 positive specimens, 83 positive cases and 6 weakly positive were identified by TPPA,the positive coincidence rate of which was 95. 70%(89/93). Among 93 positive syphilis cases detected by TP-ELISA,the 32 TRUST positive cases were confirmed,and which was positive by the TPPA detection too. Among the 61 weakly positive samples detected by TRUST,the 51 positive cases,6 weakly positive cases and 4 negative cases were identified by TPPA. Among 16 cases with the 0. 80 to 0. 99 of S/CO value,the 1 positive case and 1 weakly positive case were identified by TPPA. Conclusions:The syphilis screened by TP-ELISA exists false positive and false negative. The TRUST should be tested in TP-ELISA positive specimens at first,and the TPPA in negative TRUST specimen should be further detected to identify. The TPPA in specimens with the 0. 80 to 0. 99 of S/CO value should be further detected to decrease the misdiagnosis and missed diagnosis rates of syphilis.