不同检测方法对新生儿期先天性梅毒的诊断价值比较研究

目的：探讨比较梅毒螺旋体-酶联免疫吸附试验（TP-ELISA）、甲苯胺红不加热血清学实验（TRUST法）、梅毒螺旋体明胶颗粒凝集试验（TPPA法）和19S-IgM-TP ELISA检测4种不同方法对可疑新生儿期先天性梅毒诊断价值.方法：选取80例拟诊为新生儿期先天性梅毒患儿为研究对象,分别应用上述4种方法进行梅毒血清学检测,同时对罹患梅毒患儿进行抗病毒治疗2周,分析4种方法在治疗前后检测结果并进行随访观察.结果：四种检测方法检测的阳性率比较差异具有统计学意义（P ＜0.05）;TRUST法和19S-IgM-TP ELISA检出阳性率分别为63.75％ （51/80）和75％（60/80）;TPPA法（76/80）和TP-ELISA （78/80）检出阳性率为95％和97.5％,显著高于其他两种方法,差异具有统计学意义（P＜0.05）,且19S-IgM-TP ELISA的阳性率也明显高于TRUST法,差异有统计学意义（P＜0.05）.治疗结束后,19S-IgM-TP ELISA检测阴性结果显著高于其他三种方法（P＜0.05）,而TRUST检测阴性率则明显高于TP-ELISA法和TPPA法（P＜0.05）.结论：4种检测方法筛查梅毒各具优势而且具有潜在的联合应用前景,其中19S-IgM-TPELISA法敏感度和特异度较高,有助于早期判断新生儿期先天性梅毒治疗的早诊和疗效观察.

Diagnostic value of different methods on congenital syphilis in neonatal period

Objectives： To compare the diagnostic value of TP - ELISA, TRUST, TPPA and 19S - IgM - TPELISA for the detection of congenital syphilis in neonatal period. Method： 80 cases of suspected congenital syphilis in neonatal period were se- lected as the research objects. The above four serological testing methods were applied for syphilis diagnosis. After antiviral treat- ment on children having syphilis for 2 weeks, the analysis of the test results of the four methods were compared before and after the treatment. Results： There was statistically significant difference among the four testing methods （ P 〈 0. 05 ）. The detected positive rates of TRUST and 19S- IgM -TP ELISA were 63.75% （51/80） and 75% （60/80） respectively. Positive detected rate of TPPA and TP - ELISA were 95% and 97.5%, which were significantly higher than the results of the other three methods （ P 〈 0. 05 ）. Moreover, the positive detected rate of 19S - IgM - TP ELISA was higher than that of TRUST （ P 〈 0. 05 ）. After treatments, the negative detected rate of 19S - IgM - TP ELISA was higher than that of other three methods （ P 〈 0. 05 ）. Conclu- sion： Four kinds of detection methods of screening for syphilis are all with advantages and potential joint application prospects, and the sensitivity and specificity of 19S - IgM ＇- TP ELISA were higher to contribute to the early diagnosis of congenital syphilis.