探讨两种全自动化学发光免疫分析仪检测方法在梅毒检测中的应用价值

目的:探讨i2000和Centaur XP两种全自动化学发光免疫分析仪在梅毒检测中的应用价值。方法:选取在医院体检、门诊和住院行梅毒血清学筛查的120例患者的120份血清标本,分别使用i2000型全自动化学发光免疫分析仪化学发光微粒子免疫试验(CMIA)和Centaur XP型全自动化学发光免疫分析仪化学发光免疫试验(CLIA),对梅毒螺旋体(TP)抗体进行血清学检测。以样本吸光度与临界值的比值(S/CO)≥1.0为阳性,并与以TP明胶凝集试验(TPPA)梅毒特异性抗体确认方法平行测定的S/CO结果进行比较。结果:在120例受检者中,CMIA检测阳性结果94例,阳性率为78.33%;CLIA检测阳性结果72例,阳性率为60.00%;TPPA检测阳性结果74例,阳性率为61.67%。以TPPA试验作为确认方法,CMIA检测的灵敏度和特异度分别为97.30%和52.17%,CLIA分别为94.59%和95.65%。CMIA与TPPA检测的阳性率、符合率比较差异均有统计学意义(χ²=14.101,χ²=7.937;P<0.05)。两种全自动免疫化学发光分析法与TPPA检测的阳性符合率均呈正相关。结论:两种全自动化学发光免疫分析检测方法在梅毒S/CO值>10.00时均具有较高的灵敏度和特异度;当CMIA的S/CO值为1.00~10.00时可选用CLIA复核,缩短标本周转时间;当CLIA的S/CO值<4.70时可附加TPPA复核,以保证检测结果的准确性。

The exploration of application values of the detection methods of two kinds of automatic chemiluminescence immunoassay analyzer in syphilis detection

Objective:To explore the application value of two kinds of automatic chemiluminescence immunoassay analyzer(Abbott i2000 and Siemens Centaur XP)in syphilis detection.Methods:120 serum samples were selected from 120 patients who underwent syphilis serological screening in physical examination center,outpatient service and hospitalization department of hospital.All chemiluminescence micro-particle immunoassay(CMIA)of Abbott i2000 automatic chemiluminescence immunoassay analyzer and chemiluminescence immunoassay(CLIA)of Siemens centaur XP automatic chemiluminescence immunoassay analyzer were used respectively for serological detection of Treponema pallidum antibody.The results were judged as positive when the ratio of sample absorbance to threshold value(S/CO)was larger than and equal to 1.0.And the results were compared with the S/CO results of parallel determination of specific Treponema pallidum antibody by treponema pallidum particle agglutination(TPPA).Results:Among 120 subjects,94 cases were positive as the detection of CMIA,and the positive rate was 78.33%,while 72 cases were positive as the detection of CLIA and the positive rate was 60.00%.The positive results of TPPA experiment were 74 cases,and the positive rate of that was 61.67%.The TPPA experiment was used as the confirmed method,the sensitivity and specificity of CMIA were 97.30%and 52.17%,while those of CLIA were 94.59%and 95.65%respectively.There was statistically significant difference in the positive rate between CMIA and TPPA(χ²=14.101,P<0.05),and there was statistically significant difference in the coincidence rate between them(χ²=7.937,P<0.05).There was positive correlation between each automatic immune chemiluminescence methods and the TPPA experiment,respectively.Conclusion:Both the two automatic chemiluminescence immunoassay methods have higher sensitivity and specificity when S/CO value of syphilis is greater than 10.00.CLIA test is recommended to be used for review when S/CO value of CMIA is between 1.00 and 10.00,which can shorten turnover time of sample.TPPA test is recommended to be added for review when S/CO value of CLIA is less than 4.70,which would ensure the accuracy of detection results.