酶联免疫吸附试验在梅毒螺旋体感染诊断中的应用价值
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摘要
目的探讨酶联免疫吸附试验(ELISA)在梅毒螺旋体感染诊断中的应用价值。方法选择2017年5月至2018年7月我院收治的疑似梅毒螺旋体感染者86例为研究对象,所有患者入院后取空腹静脉血5 mL,血清分离后采用ELISA完成梅毒螺旋体,检查完毕后行甲基胺红不加热血清试验(TRUST)检查,将两种方法检查结果与梅毒螺旋体抗体吸收实验(FTA-ABS)检查结果(金标准)进行比较。比较两种检查方法的诊断符合率,并分析ELISA法、TRUST法及两者联合检查的诊断效能。结果 86例受检者均经FTA-ABS法检查最终确诊,其中阳性患者68例,占比为79.07%。ELISA法检查最终确诊66例阳性患者,20例阴性患者,诊断符合率为93.02%;TRUST法检查最终确诊60例阳性患者,26例阴性患者,诊断符合率为81.40%;ELISA法的诊断符合率显著高于TRUST法,差异有统计学意义(P<0.05)。联合检查与ELISA法诊断的灵敏度均显著高于TRUST法(P<0.05)。结论 ELISA法用于梅毒螺旋体感染检查中能获得较高的诊断效能,且与金标准的诊断符合率较高,其联合TRUST检查能提高临床确诊率,为临床诊疗提供依据和参考。
Objective To explore the value of enzyme-linked immunosorbent assay(ELISA) in the diagnosis of Treponema pallidum infection. Methods A total of 86 suspected cases of Treponema pallidum infection admitted in our hospital from May 2017 to July 2018 were selected as the study objects. Five mL fasting venous blood was taken from all patients after admission, after serum separation, ELISA was used to detect Treponema pallidum, and tolulized red unheated serum test(TRUST) was performed after examination. The results of two methods were compared with those of fluoresent treponemal antibody-absorption test(FTA-ABS)(gold standard). The diagnostic coincidence rates of the two methods were compared, and the diagnostic efficacy of ELISA, TRUST and their combined detection were analyzed. Results All the 86 subjects were finally diagnosed by FTA-ABS examination, among which 68 were positive, accounting for 79.07%. ELISA finally confirmed 66 cases of positive patients and 20 cases of negative patients, the diagnostic coincidence rate was93.02%; there were 60 cases of positive patients and 26 cases of negative patients finally diagnosed by TRUST, and the diagnostic coincidence rate was 81.40%; the diagnostic coincidence rate of ELISA was significantly higher than that of TRUST(P <0.05). The sensitivity of combined examination and ELISA were significantly higher than that of TRUST(P<0.05). Conclusion ELISA has a high diagnostic efficiency in the detection of Treponema pallidum infection and a high coincidence rate with the gold standard. ELISA combined with TRUST examination can improve the clinical diagnosis rate and provide basis and reference for clinical diagnosis and treatment.
Objective To explore the value of enzyme-linked immunosorbent assay(ELISA) in the diagnosis of Treponema pallidum infection. Methods A total of 86 suspected cases of Treponema pallidum infection admitted in our hospital from May 2017 to July 2018 were selected as the study objects. Five mL fasting venous blood was taken from all patients after admission, after serum separation, ELISA was used to detect Treponema pallidum, and tolulized red unheated serum test(TRUST) was performed after examination. The results of two methods were compared with those of fluoresent treponemal antibody-absorption test(FTA-ABS)(gold standard). The diagnostic coincidence rates of the two methods were compared, and the diagnostic efficacy of ELISA, TRUST and their combined detection were analyzed. Results All the 86 subjects were finally diagnosed by FTA-ABS examination, among which 68 were positive, accounting for 79.07%. ELISA finally confirmed 66 cases of positive patients and 20 cases of negative patients, the diagnostic coincidence rate was93.02%; there were 60 cases of positive patients and 26 cases of negative patients finally diagnosed by TRUST, and the diagnostic coincidence rate was 81.40%; the diagnostic coincidence rate of ELISA was significantly higher than that of TRUST(P <0.05). The sensitivity of combined examination and ELISA were significantly higher than that of TRUST(P<0.05). Conclusion ELISA has a high diagnostic efficiency in the detection of Treponema pallidum infection and a high coincidence rate with the gold standard. ELISA combined with TRUST examination can improve the clinical diagnosis rate and provide basis and reference for clinical diagnosis and treatment.
引文
[1]孟保福,宋红林,李翠芬.ELISA法在诊断梅毒螺旋体感染中的临床检验价值[J].中华医院感染学杂志,2016,26(20):4611-4613.
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[7]严薛丹,王军荐,胡宏章.梅毒血清学检测方法的应用价值[J].检验医学与临床,2016,13(A2):290-292.
[8]韩红星.ELISA方法检测MP-IgM与冷凝集试验对小儿肺炎支原体感染诊断价值的比较[J].标记免疫分析与临床,2016,23(4):446-447.
[9]徐俊,郭楠,刘敏.酶联免疫法筛查HIV抗体在艾滋病诊断中的应用价值[J].国际病毒学杂志,2016,23(1):53-56.
[10]贾伟,褚福禄,张杰,等.TPPA、ELISA、RPR三种方法检测梅毒的灵敏度及特异度对比[J].中国性科学,2017,26(5):75-77.
[11]姚春红,褚靖,邓建平.CLIA与TP-ELISA检测梅毒螺旋体抗体的Meta分析[J].临床输血与检验,2016,18(4):365-368.
[12]杨军兰,行宁,张雷,等.酶联免疫法与金标法对梅毒的检测效果比较[J].陕西医学杂志,2017,46(9):1305-1307.
[13]王晓伟,靳丽丽,邵春燕,等.人免疫球蛋白对血液病患者梅毒螺旋体抗体检测的影响[J].临床输血与检验,2017,19(1):40-43.
[14]钟小芬,毛凌哲.不同梅毒血清学试验联合运用价值分析[J].检验医学,2016,31(3):217-219.
[15]张瑞芳,高丽华,董宇青.对比分析不同梅毒检验方法在梅毒螺旋体检测中的临床效果[J].中国性科学,2016,25(5):90-92.
[15]赵鹏鹏,吴红,魏正闵.284例早期梅毒病例临床分析[J].中国麻风皮肤病杂志,2017,33(2):110-111.
[16]俞士勇.梅毒螺旋体抗体检测ELISA法与TPPA法相关性研究[J].中国农村卫生,2017,3(16):38.
[17]高亚春.ELISA法梅毒抗体检测与TRUST试验在梅毒诊断中的应用价值[J].临床医药文献电子杂志,2017,4(46):9028.
[18]陈嘉怡.不同检验方法检测梅毒螺旋体的结果准确率对比分析[J].医药卫生:文摘版,2016,9(4):49.
[19]刘秀娟.ELISA法在诊断梅毒螺旋体感染中的临床检验价值研究[J].临床医药文献电子杂志,2016,3(53):10601.
[20]夏芳,徐元宏,汪学龙.梅毒螺旋体抗体血清学检测方法的临床应用价值探讨[J].中华流行病学杂志,2016,37(6):863-867.
[21]东立.ELISA法在诊断梅毒螺旋体感染中的临床价值及应用[J].临床和实验医学杂志,2013,12(1):61.
[22]姜景霞.ELISA法在诊断梅毒螺旋体感染中的临床检验价值[J].继续医学教育,2017,31(3):142-143.
[23]王莹.ELISA法在诊断梅毒螺旋体感染中的临床检验价值分析[J].中国医药指南,2015,13(28):62-63.
[2]吕松琴,赵华,宝福凯,等.ECLIA法与ELISA法在梅毒诊断中的临床价值的对比[J].昆明医科大学学报,2016,37(4):124-127.
[3]谭旭斌.3TP法与ELISA法检测梅毒螺旋体抗体的价值对比研究[J].河北医学,2016,22(2):344-346.
[4]叶霞,徐清芳,魏靖,等.TP-ELISA、TPPA、RPR联合检测在梅毒诊断中的应用价值[J].热带医学杂志,2017,17(5):93-96.
[5]李瑛,李军.TP-ELISA、RPR与TPPA检测诊断梅毒的临床意义[J].陕西医学杂志,2016,45(10):1398-1399.
[6]石海萍,周晓芹.酶联免疫斑点法和ELISA法诊断结核病临床价值的探讨[J].中国医药导刊,2016,18(7):651-652.
[7]严薛丹,王军荐,胡宏章.梅毒血清学检测方法的应用价值[J].检验医学与临床,2016,13(A2):290-292.
[8]韩红星.ELISA方法检测MP-IgM与冷凝集试验对小儿肺炎支原体感染诊断价值的比较[J].标记免疫分析与临床,2016,23(4):446-447.
[9]徐俊,郭楠,刘敏.酶联免疫法筛查HIV抗体在艾滋病诊断中的应用价值[J].国际病毒学杂志,2016,23(1):53-56.
[10]贾伟,褚福禄,张杰,等.TPPA、ELISA、RPR三种方法检测梅毒的灵敏度及特异度对比[J].中国性科学,2017,26(5):75-77.
[11]姚春红,褚靖,邓建平.CLIA与TP-ELISA检测梅毒螺旋体抗体的Meta分析[J].临床输血与检验,2016,18(4):365-368.
[12]杨军兰,行宁,张雷,等.酶联免疫法与金标法对梅毒的检测效果比较[J].陕西医学杂志,2017,46(9):1305-1307.
[13]王晓伟,靳丽丽,邵春燕,等.人免疫球蛋白对血液病患者梅毒螺旋体抗体检测的影响[J].临床输血与检验,2017,19(1):40-43.
[14]钟小芬,毛凌哲.不同梅毒血清学试验联合运用价值分析[J].检验医学,2016,31(3):217-219.
[15]张瑞芳,高丽华,董宇青.对比分析不同梅毒检验方法在梅毒螺旋体检测中的临床效果[J].中国性科学,2016,25(5):90-92.
[15]赵鹏鹏,吴红,魏正闵.284例早期梅毒病例临床分析[J].中国麻风皮肤病杂志,2017,33(2):110-111.
[16]俞士勇.梅毒螺旋体抗体检测ELISA法与TPPA法相关性研究[J].中国农村卫生,2017,3(16):38.
[17]高亚春.ELISA法梅毒抗体检测与TRUST试验在梅毒诊断中的应用价值[J].临床医药文献电子杂志,2017,4(46):9028.
[18]陈嘉怡.不同检验方法检测梅毒螺旋体的结果准确率对比分析[J].医药卫生:文摘版,2016,9(4):49.
[19]刘秀娟.ELISA法在诊断梅毒螺旋体感染中的临床检验价值研究[J].临床医药文献电子杂志,2016,3(53):10601.
[20]夏芳,徐元宏,汪学龙.梅毒螺旋体抗体血清学检测方法的临床应用价值探讨[J].中华流行病学杂志,2016,37(6):863-867.
[21]东立.ELISA法在诊断梅毒螺旋体感染中的临床价值及应用[J].临床和实验医学杂志,2013,12(1):61.
[22]姜景霞.ELISA法在诊断梅毒螺旋体感染中的临床检验价值[J].继续医学教育,2017,31(3):142-143.
[23]王莹.ELISA法在诊断梅毒螺旋体感染中的临床检验价值分析[J].中国医药指南,2015,13(28):62-63.