四种梅毒血清学检测方法临床应用评价

目的:了解快速血浆反应素试验(RPR)、梅毒螺旋体明胶凝集试验(TPPA)、胶体金免疫层析法和酶联免疫吸附试验(ELISA)的临床应用和价值。方法:采用RPR、TPPA、胶体金法和ELISA同时对4241例监测对象的标本进行检测,以TPPA作为参考标准,分别统计RPR、胶体金法和ELISA的敏感性、特异性、阳性预测值和阴性预测值。结果:RPR、胶体金法、ELISA诊断梅毒的敏感性分别为66.80%、97.27%、98.18%,特异性分别为99.72%、99.43%、99.55%;胶体金法、ELISA与TPPA检测阳性率差异无统计学意义(P>0.05),RPR与TPPA法检测结果差异有统计学意义(P<0.05)。结论:TP-ELISA法具有较高的敏感性和特异性法,可用于临床筛查和梅毒感染的确证试验。

Evaluation of four kinds of syphilis serological test method in clinical application

Objective:To investigate the clinical utilization and value of rapid plasma reagin(RPR),Treponema pallidum particle agglutination(TPPA),gold-immunochromatography assay(GICA) and enzyme-linked immunosorben assay(ELISA) in the diagnosis of syphilis.Methods:Four serological tests including RPR,TPPA,GICA and ELISA were employed to detect the samples from 4241 monitoring objects.The sensitivity,specificity,positive predictive value and negative predictive value of RPR,GICA and ELISA were calculated statistically with the results of TPPA as reference.Results:The overall sensitivities for syphilis by the RPR,GICA and ELISA test were 66.80%,97.27%,98.18% respectively,while the specificities were 99.72%,99.43%,99.55%;There was significant difference in the detection result between RPR and TPPA method(P<0.05),while no marked difference was noted between ELISA and TPPA,also between GICA and TPPA(P>0.05).Conclusion:TP-ELISA was a highly specific and sensitive method in syphilis screening and it can be the final diagnosis of syphilis.