TP-光激化学发光、TPPA、TRUST试验的临床应用评价

目的 通过对TP-光激化学发光、梅毒螺旋体明胶颗粒凝集试验（TPPA）、甲苯胺红不加热血清试验（TRUST）的临床应用进行评价，为临床医生在不同情况下选择梅毒螺旋体抗体检测方法提供依据。方法 选取2019年4月1日~7月31日我院11619例住院患者、2458例门诊患者及2983例健康体检者进行TP-光激化学发光和TRUST检测，将TP-光激化学发光检测阳性或TRUST检测阳性的标本进行TPPA法检测，比较TP-光激化学发光及TRUST检测结果，TP-光激化学发光、TRUST检测及TPPA法检测结果及检测梅毒螺旋体抗体的诊断价值，TP-光激化学发光、TRUST检测梅毒螺旋体抗体的诊断价值及TP-光激化学发光法S/CO值与TPPA结果。结果 TP-光激化学发光检测门诊阳性率为6.18%，住院阳性率为3.46%，体检阳性率为0.67%；TRUST检测门诊阳性率为3.42%，住院阳性率为1.11%，体检阳性率0.27%。对557例TP-光激化学发光阳性和222例TRUST检测阳性的标本同时进行TPPA法检测，TPPA法阳性率为79.73%，TP-光激化学发光阳性率为98.30%，TRUST阳性率为37.82%，三种方法检测结果两两比较，差异有统计学意义（P＜0.05）。TRUST检测梅毒螺旋体抗体的敏感度低于TP-光激化学发光，差异有统计学意义（P＜0.05）。以TPPA结果为标准，通过对TP-光激化学发光结果的S/CO值分段分析，结果显示S/CO值越高，与TPPA的阳性符合率越高。结论 TP-光激化学发光灵敏度高，适用于梅毒的感染筛查及辅助诊断；TPPA法检测适用于梅毒感染的确诊，能有效排除TP-光激化学发光和TRUST假阳性的问题；TRUST检测灵敏度较低，对梅毒螺旋体的筛查结果准确性不及TP-光激化学发光和TPPA法检测，不适合用于梅毒感染的筛查，可联和使用TP-光激化学发光以提高诊断梅毒的准确率。

Clinical Application Evaluation of TP-photoexcited Chemiluminescence,TPPA and TRUST Test

Objective To evaluate the clinical application of TP-photochemiluminescence, treponema pallidum gelatin aggregation test (TPPA) and toluidine red non-heated serum test (TRUST), and provide a basis for clinicians to choose the detection method of Treponema pallidum under different conditions. Methods From April 1st to July 31st, 2019, 11619 inpatients, 2458 outpatients and 2983 physical examination patients in our hospital underwent TP-photochemiluminescence and TRUST test, and TP-photochemiluminescence detection was positive or TRUST Detecting positive samples by TPPA method, comparing TP-photoexcited chemiluminescence and TRUST detection results, TP-photoexcited chemiluminescence, TRUST detection and TPPA detection results and detection of syphilis antibody diagnostic value, TP-photochemical chemiluminescence , TRUST test the diagnostic value of Treponema pallidum antibody and TP-photochemiluminescence S/CO value and TPPA results.Results The positive rate of TP-photochemiluminescence detection was 6.18%, the hospitalization positive rate was 3.46%, the positive rate of physical examination was 0.67%; the positive rate of TRUST test was 3.42%, the hospitalization positive rate was 1.11%, and the positive rate of physical examination was 0.27%. 557 cases of TP-photoexcited chemiluminescence and 222 positive samples were tested by TPPA. The positive rate of TPPA was 79.73%, the positive rate of TP-photochemiluminescence was 98.30%, and the positive rate of TRUST was 37.82%. The results of the three methods were compared,the difference was statistically significant (P<0.05). The sensitivity of the TRUST test for Treponema pallidum was lower than that of TP-photochemiluminescence,the difference was statistically significant (P<0.05). Based on the TPPA results, the S/CO value of the TP-photoexcited chemiluminescence results was analyzed by segmentation. The results showed that the higher the S/CO value, the higher the positive coincidence rate with TPPA.Conclusion TP-photosensitive chemiluminescence sensitivity is high, suitable for syphilis infection screening and auxiliary diagnosis; TPPA method is suitable for syphilis infection confirmation, can effectively eliminate TP-photoexcited chemiluminescence and TRUST false positive problem; TRUST detection sensitivity low, the screening results of Treponema pallidum are less accurate than TP-photochemiluminescence and TPPA detection, not suitable for screening for syphilis infection, and can be combined with TP-photochemiluminescence to improve the accuracy of diagnosis of syphilis.