梅毒血清学新筛查模式的可行性评价

目的 探讨筛查苍白密螺旋体抗原血清试验的新模式及对梅毒进行筛查的可行性.方法 收集临床需做梅毒筛查试验的标本1584份,对这1584份标本分别使用化学发光法(CLIA)和苍白密螺旋体明胶颗粒凝集试验(TPPA),检测梅毒特异性抗体,其中任一方法阳性标本再使用甲苯胺红不加热血清试验(TRUST)进行滴度检测.结果 CLIA阳性57份标本,阳性率为3.6％,TPPA阳性为56份标本,阳性率为3.5％,两种方法阳性率差异无统计学意义,符合率达99.9％ (Kappa=0.995),57份阳性标本中,TRUST检出阳性为35份,阳性检出率为61.4％,低于CLIA的100.0％及TPPA的98.2％,差异均有统计学意义(P＜0.01).结论 使用CIIA检测梅毒特异性抗体做确证试验,阳性再做TRUST及滴度检测的新模式是可行的,提高了敏感性,降低了假阴性,优于目前使用的传统梅毒筛查模式.

Feasibility of a new serological screening model of syphilis

OBJECTIVE To investigate the feasibility of a new serological screening model of syphilis which non-treponemal antigen serum test was performed as the first test is positive.METHODS A total of 1584 clinical samples were screened for syphilis with chemiluminescence immunoassay(CLIA) and treponema pallidum gelatin particle agglutination test(TPPA),respectively.The positive samples were retested by toluidine red unheated serum test(TRUST).RESULTS Totally 57 and 56 samples were detected by CLIA and TPPA with positive rate of 3.6% and 3.5%,respectively,there was no significant difference in positive rate between the two methods,and there was 99.9% of the coincidence rate between them(Kappa=0.995,P<0.01).Of 57 positive samples,35 were detected by TRUST with detection rate of 61.4%,which was lower than that by CLIA(100.0%) and TPPA(98.2%),there was statistically significant difference(all P<0.01).CONCLUSION The new screening model of syphilis with specific antibody of treponema pallidum detected by CLIA as confirmation test and then the positive samples retested by TRUST is feasible,which can increase sensitivity and lower false-negative and is better than currently used traditional screening model of syphilis.