CLIA、TRUST和TPPA 3种梅毒检测方法的比较

Comparison of three methods to diagnose syphilis, CLIA, TRUST and TPPA

    摘要
  • 摘要:
    目的 通过比较化学发光免疫分析（CLIA）、梅毒螺旋体明胶凝集试验（TPPA）、甲苯胺红不加热血清试验（TRUST）3种梅毒检测方法的优缺点，为临床选择合适的梅毒检验方法。
    方法 随机选取已确诊为梅毒感染的患者446例和非梅毒感染的健康体检者398例。分别采用CLIA、TRUST、TPPA法对血清中的梅毒抗体进行检测，评价3种方法之间的差异及临床应用。
    结果 在对梅毒患者的血清检测中，CLIA、TRUST和TPPA的灵敏度分别为98.2%，80.3%和94.8%；特异度分别为98.5%、76.4%和99.7%。在对照组中，CLIA、TRUST和TPPA的假阳性率分别为1.5%、23.6%和0.2%。
    结论 CLIA的灵敏度高于TPPA，重复性好，操作简便，可用于梅毒初筛，但CLIA的特异度低于TPPA，因此CLIA的阳性标本应结合TPPA及临床症状确诊。TRUST的灵敏度及特异度均低于CLIA和TPPA。因此，TRUST主要用于梅毒的临床疗效观察。

     

    Abstract:
    Objective To compare the strengths and weaknesses of chemiluminescence immune assay(CLIA), treponema pallidum particle agglutination test(TPPA), toluidine red unheated serum test(TRUST)in syphilis testing, and choose the appropriate method for clinical syphilis testing.
    Methods A total of 446 syphilitic and 398 health control were enrolled in this subject. Three kinds of syphilis testing methods(CLIA, TRUST, TPPA) were used to detect treponema pallidum, and the difference and clinical practice of these methods were compared.
    Results The detection sensitivity of CLIA, TRUST and TPPA were 98.2%, 80.3% and 94.8%, respectively; While the specificity of CLIA, TRUST and TPPA were 98.5%, 76.4% and 99.7%, respectively. The false positive rate of CLIA, TRUST and TPPA in control group were 1.5%, 23.6% and 0.2%, respectively.
    Conclusions Compared with TPPA, the sensitivity of CLIA were higher. CLIA was well reproducible and easy to operate, which can be used for syphilis screening. And the positive samples should be combined with TPPA results and clinical symptoms to diagnose TP. The TRUST method is mainly used to evaluate clinical effects of syphilis.

     

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