ELISA法筛查联合TRUST、TPPA在梅毒诊断中的应用价值

目的探讨酶联免疫吸附试验(ELISA)梅毒筛查联合梅毒甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体明胶凝集试验(TPPA)在梅毒检测中的应用价值,建立本实验室梅毒检测和报告系统。方法用ELISA法作为临床标本的梅毒筛查,对筛查阳性标本和S/CO值在0.70~0.99范围的疑似标本,进一步作TRUST和TPPA。结果TP-ELISA法检出的145例梅毒阳性标本,TPPA确证阳性141例,阳性符合率为97.24%(141/145);其中91例TRUST阳性,且TP-PA确证实验均为阳性;54例TRUST阴性,TPPA确证50例阳性,4例为阴性。20例S/CO值在0.70~0.99之间的标本中,TPPA阳性4例。4份阳性标本的倍比稀释后检测结果也说明ELISA敏感性低于TPPA。结论梅毒ELISA法筛查存在着一定的假阳性和假阴性结果。TP-ELISA阳性标本首先应做TRUST,而对TRUST阴性标本应进一步用TPPA确证;对S/CO值在0.70~0.99之间的疑似标本也应用TPPA确证,以减少梅毒的误诊和漏诊。

Evaluation of TP-ELISA Screening Combined with TRUST and TPPA in Diagnosis of Syphilis

Objective To explore the value of using ELISA as a routine screening method combined with TRUST and TPPA for the diagnosis of syphilis,and establish the system of test and report for serological diagnosis of treponema infection in our laboratory.Methods The clinical specimens underwent routine treponema pallidum antibody screening with ELISA method.All positive samples and the suspicious samples that S/CO value was between 0.7 and 0.99 by TP-ELISA were further tested by TRUST and TPPA.Results Among 145 treponema pallidum antibody screening positive specimens,141 positive and 4 negative results were retested by TPPA.The positive coincidence rate of ELISA and TPPA was 97.24 %.91 positives results were detected with TRUST,which were the same positives results as with TPPA.Among 54 TRUST negative samples,50 positives results were detected with TPPA.4 positives results were detected with TPPA for 20 suspicious samples that S/CO value was between 0.7 and 0.99 by ELISA.TPPA was more sensitive than ELISA by 4 positive samples in the dilution test.Conclusions TP-ELISA screening test exist several false positives and false negative results.ELISA screening positive specimens should be firstly detected with TRUST.All TRUST negative samples and the suspicious samples that S/CO value is between 0.7 and 0.99 by ELISA should be further tested by TPPA,which can greatly reduce the erroneous or escape diagnosis of Syphilis.