早期梅毒实验室检测方法的评价

目的:评价在梅毒早期诊断中,四种梅毒血清学检测方法的比较及在临床诊断中应用价值。方法:应用快速血浆反应素试验(RPR)、梅毒螺旋体血球凝集试验(TPHA)、梅毒螺旋体明胶凝集试验(TPPA)、酶联免疫吸附试验(ELISA)检测182例血清标本。结果:RPR、TPHA、TPPA、ELISA的敏感性分别为88.3%、92.2%、94.8%、98.7%,特异性分别为85.7%、94.3%、96.2%、98.1%,其中RPR、TPHA、TPPA与灵敏性、特异性较好的ELISA比较,RPR、TPHA、TPPA的敏感性较低,差异有显著性(P<0.05),特异性方面,除TPHA、TPPA差异无显著性(P>0.05),RPR低于ELISA,差异有显著性(P<0.05);RPR滴度随治疗时间的增加而逐渐下降。结论:ELISA方法操作简单,结果判断可标准化,特异性高,敏感性高,可作为早期梅毒检测较理想的方法,RPR试验可用于梅毒治疗期间的疗效判定。

Evaluation on the Laboratory Detection of Early Syphillis

Objective The sensitivity and specificity of four kinds methods detecting Treponema pallium antibody were compared and clinical application values, which were analyzed in the Early Syphillis.Methods To detect the antibody of Treponema pallidum in 182 serum specimens with RPR、TPHA、TPPA and ELISA methods.Results The sensitivities of the four approaches(RPR、TPHA、TPPA and ELISA) were 88.3%、92.2%、94.8%、98.7%,the specificites of the four approaches were 85.7%、94.3%、96.2%、98.1%,the sensitivities of RPR、TPHA、TPPA were lower than that of the ELISA(P<0.05);except TPHA、TPPA,the specificity of RPR was lower than that of the ELISA(P<0.05);The titers of RPR tests decreased along with the duration after treatment.Conclusion The ELISA is easy to use and has high sensitivity and specificity,it is suggested that ELISA is better than the other laboratory diagnosis of early syphilis.The titer of RPR test is a useful serologic index for the observation of therapeutic effects.