梅毒螺旋体感染不同血清学诊断方法的临床评价

目的：使用酶联免疫吸附测试验（ELISA）方法替代快速血浆反应素试验（RPR）和甲苯胺红不加热血清试验（TRUST）方法确定诊断梅毒螺旋体感染的必要性。方法：使用目前国内最为常用的梅毒螺旋体感染诊断RPR和TRUST试剂及ELISA试剂检测阴阳性献血员标本，同时与梅毒螺旋体明胶凝剂试验（TPPA）的检测结果进行比较，从而得到各种试剂的检测假阴性和假阳性率。结果：在对30份阳性和20份阴性标本的检测中，所用一种RPR试剂和两种TRUST试剂的假阳性率，分别为15．0％（3／20）、10．0％（2／20）和10．0％（2／20），假阴性率分别为30．0％（9／30）、23．3％（7／30）和43．3％（13／30）；而两种ELISA试剂均无假阳性，有一家试剂出现1例假阴性。ELISA试剂的假阳性和假阴性率均明显低于RPR和TRUST试剂（P＜0．01）。结论：在梅毒螺旋体抗体的临床检测中，有必要使用ELISA方法替代RPR和TRUST方法。

Clinical evaluation of different serological diagnosis methods of syphilis

Objective To determinate the necessity of using ELISA method to substitute for RPR and TRUST in serological diagnosis of treponemal infection Methods The one kind of RPR kit and two kinds of TRUST kits the most frequently used in China at present were used to detect fifty serum samples from donors with or without syphilis The results of above different methods were compared with the result obtained using TPPA method Then,the false positive rate and false negative rate of the different methods can be calculated Results The false positive rate and false negative rate of the RPR kit (15 0% and 30 0%) and two kinds of TRUST kits (10 0%,10 0% and 23 3%,43 3%) were significantly higher than those of the ELISA kits(0 0%,0 0% and 0 0%,3 3%)( P <0 01) Conclusion It is necessary to use ELISA method to substitute for RPR and TRUST in serological diagnosis of treponemal infection