三种梅毒螺旋体抗体检测方法的比较分析

目的比较化学发光法（TP-CLIA）、酶联免疫吸附试验（TP-ELlSA）和梅毒螺旋体明胶颗粒凝聚试验（TPPA）对梅毒螺旋体特异性抗体（TP-Ab）检测的意义。方法分别用CLIA、ELISA和TPPA检测患者的1797份血清样本，收集CLIA／ELISA／TPPA／法检测均阳性但临床未明确诊断的标本及结果不一致标本以重组免疫印迹法（RIBA）最终确认。结果三种方法共筛选69例阳性及可疑血清标本。CIIA／EIISA／TPPA法均阳性标本63例，其中52例有临床明确诊断。另11例3种方法检测均阳性但未明确诊断标本和6例检测结果不一致标本用RIBA确证。CLIA法确认阳性66例，阳性率3．67；ELISA法确认阳性65例，阳性率3．62；TPPA法法确认阳性61例，阳性率3．39；CLIA、ELISA及TPPA法敏感性分别为98．51％、97．02％和91．05％；特异性均为99．88；诊断效率分别99．83％、99．78和99．66％。结论CLIA法和ELISA法敏感性均高于TPPA法，不管用何种方法检测对于临床诊断不符的标本均应慎重，必要时用RIBA法补充确认，以排除假阳性。

Experimental evaluation on the determination of specific antibodies to Treponema pallidum using three different methods

Objective To compare the consistency of chemilurninescent immunoassay （CLIA）,enzyme-linked imrnunosorbent as- say （ELISA） and Treponema pallidum particle agglutination （TPPA） in detecting the specific antibody against Treponema pallidu- rain in patient serum. Methods 1 797 serum samples were collected and detected by TP- CLIA,TP-ELISA and TPPA. The positive samples were confirmed by recombinent immunoblot assay （RIBA）. Results In 1797 serum samples,66 were positive for CLIA;65 were positive for TP-ELISA; 61 were positive for TPPA, 17 serum samples with contradictory results were determined by RIBA. The Sensitivity was 98.51%, 97.02 % and 91.05% ,and diagnostic efficiency was 99.83 %, 99.78 % and 99.66 %,respectively. All three methods have the same specificity of 99.88%. Conclusion The sensitivities of CLIA and TP-ELISA are better than that of TPPA. CLIA should be combined with TPPA and confirmed by clinical information.