TPPA和酶联免疫吸附法在梅毒诊断中的作用

目的比较分析TPPA与酶联免疫吸附法对诊断梅毒感染的区别，探讨TPPA与酶联免疫吸附法在梅毒诊断中的优势。方法随机选取2011年1月～2013年10月到我中心性病门诊就诊的病患260例作为研究对象，通过随机分组的原则分为实验组和对照组，每组130例研究对象，实验组采取TPPA方法对研究对象进行梅毒螺旋体抗体检测，而对照组采取酶联免疫吸附法对研究对象进行梅毒螺旋体抗体检测。结果在实验组的130例研究对象中，梅毒螺旋体抗体TPPA方法检测的阳性率为26．92％（35／130）；在对照组的130例研究对象中，酶联免疫吸附法检测的阳性率为20．00％（26／130）。如果将酶联免疫吸附法作为诊断的金标准，TPPA测定结果的敏感度为93．65％，测定的特异性为97．68％。结论在对梅毒螺旋体抗体检测的敏感度和特异性检测方面，TPPA检测法的特异性比酶联免疫吸附法好，但酶联免疫吸附法的敏感性较TPPA检测法高。在临床中应将酶联免疫吸附法作为梅毒的筛选试验，对于筛选阳性的样本，应用TPPA方法去确诊，只要将两种方法有效的结合起来，才能避免漏检和误诊，具有良好的可重复性等优点，值得临床应用推广。

Role of TPPA and enzyme linked immunosorbent assay in diagnosis of syphilis

Objective To compare and analyze the differences between TPPA and enzyme linked immunosorbent assay in the diagnosis of syphilis and to explore their advantages. Methods 260 patients treated in the STD outpatient of our center from January 2011 to October 2013 were selected as the study subjects and randomly divided into the experimental group and the control group, with 130 patients in each group. The experimental group used TPPA to detect Treponema pallidum antibodies and the control group used enzyme linked immunosorbent assay to detect Treponema pallidum antibodies. Results In the experimental group, the positive rate of TPPA detection of Treponema pallidum antibodies was 26.92%（35/130）; In the control group, the positive rate of TPPA detection of Treponema pallidum antibodies was 20.00%（26/130）. If the enzyme linked immunosorbent assay served as the gold diagnostic standards, the sensitivity and specificity of TPPA were 93.65% and 97.68% respectively. Conclusion In terms of sensitivity and specificity of Treponema pallidum antibodies detection, TPPA has better specificity than enzyme linked immunosorbent assay, but enzyme linked immunosorbent assay has higher sensitivity than TPPA. In clinical practice, enzyme linked immunosorbent assay should serve as the screening test of syphilis, and for the screened positive samples, TPPA should be used to confirm the diagnosis. Only by effective combination of the two methods, misdiagnosis and missed diagnosis can be avoided, and the combined method has the advantages of good repeatability, thereby worthy of clinical application and promotion.