脑脊液快速血浆反应素试验与性病研究实验室试验用于神经性梅毒诊断的比较研究

目的比较传统的快速血浆反应素试验（RPR）与性病研究实验室试验（VDRL）用于诊断神经性梅毒的敏感性和特异性,探讨RPR是否能用于神经性梅毒的诊断。方法采用RPR、VDRL和荧光密螺旋体抗体吸附试验（FTA-ABS）对244例患者（有症状型神经梅毒9例,无症状型神经梅毒18例;一期梅毒5例,二期梅毒7例,潜伏期梅毒65例;经治疗的梅毒50例和其它非梅毒性神经系统疾病90例）的脑脊液（CSF）标本进行试验并对结果进行分析。结果以临床诊断结果为标准,RPR脑脊液敏感性为99.1%,特异性为77.8%。VDRL试验脑脊液敏感性为98.6%,特异性为70.4%。结论 RPR和VDRL都用于测定CSF标本时,两者具有相似的特异性和敏感性,RPR可以代替VDRL用于神经性梅毒的诊断。

Sensitivity and spedncity of the venereal disease research laboratory (VDRL) and the rapid plasma reagin (RPR)tests in the diagnosis of neurosyphilis:a comparative study

Objective To find out if the rapid plasma reagin（RPR）could be an alternative to the VDRL.Methods Cerebrospinal fluid（CSF） and sera samples from 244 patients in the following stages of syphilis were tested： 9 had symptomatic and 18 asymptomatic neurosyphilis,5 were in the primary stage,7 had secondary syphilis,and 65 were in the latent stage.We have also studied 50 samples from individuals with treated syphilis and 90 with other neurological diseases than neurosyphilis.All the CSF samples were studied with RPR,VDRL and Fluorescent Treponemal Antibody Absorption Assay tests（FTA-Abs）.Results T RPR and VDRL test results were mostly concordant.The specificity of these tests for current neurosyphilis was 99.1% for the RPR and 98.6% for the VDRL,whereas the sensitivity was 77.8% and 70.4%,respectively,for the VDRL and RPR.Conclusion In view of these results it seems to us that the RPR could be an alternative to the VDRL in the diagnosis of neurosyphilis.