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梅毒是一种由梅毒螺旋体感染机体所引起的慢性全身性疾病,它主要通过性接触传播,是较常见的性传播疾病。此外,母婴传播、输血传播也是梅毒的传播方式。近年来,我国梅毒的感染人数急剧增多,严重危害了人类的健康。梅毒的早期诊断和及时治疗可以有效地减少梅毒感染的危害。目前,国内外检测梅毒的方法主要有梅毒螺旋体明胶凝集试验(treponemal pallidum particle agglutination test,TPPA)、甲苯胺红不加热血清试验(toluidine red unheatedserum test,TRUST)、梅毒螺旋体酶联免疫吸附试验、胶体金试纸法以及梅毒的化学发光免疫分析(chemiluminescence immune assay,CLIA)法。本研究通过比较CLIA、TPPA、TRUST 3种检测方法的优缺点,为临床诊断及疗效监测提供更为合适的检验方法。
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
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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。 -
关键词:
- 梅毒 /
- 化学发光免疫分析 /
- 甲苯胺红不加热血清试验 /
- 梅毒螺旋体明胶凝集试验
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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