探讨TRUST和TPPA法联合检测梅毒螺旋体抗体的临床价值
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摘要
目的探讨酶联免疫吸附试验(ELISA)、甲苯胺红不加热血清实验(TRUST)、梅毒螺旋体明胶颗粒凝集试验(TPPA)以及联合检验对梅毒螺旋体(Treponema pallidum,TP)抗体的临床价值。方法选取2015年1月—2017年12月来本院进行检查的287例疑似梅毒患者作为研究对象,先行ELISA法进行TP抗体血清学筛查,再行TRUST和TPPA法检测,以《梅毒诊断标准》进行确诊,比较三种检查方法的诊断准确率以及联合检测的诊断价值。结果 ELISA法和TPPA法对疑似梅毒的诊断准确率(分别为93.38%和95.82%)均高于TRUST法(84.32%),差异有统计学意义(P<0.05);三种检查方法对梅毒诊断的灵敏度在68.97%～94.83%之间,特异度在94.74%～96.49%之间,约登指数在0.637～0.913之间; ELISA法筛查的基础上,进行TRUST+TPPA联合检测,其灵敏度、特异度和约登指数均较高,分别为98.28%、94.74%和0.930。结论 ELISA法和TPPA法对疑似梅毒的诊断符合率较高,三种方法联合检测的诊断价值高,可先行ELISA法筛查,再进行TRUST法和TPPA法联合检测提高梅毒诊断的临床价值。
Objective To explore the clinical value of enzyme-linked immunosorbent assay( ELISA),tolulized red unheated serum test( TRUST),treponema pallidum particle assay( TPPA) and combined detection of them for treponema pallidum antibodies. Methods 287 patients of suspected syphilis,visit our hospital for examination during January 2015 and December 2017,were selected as study subjects. They were screened for TP antibody by ELISA,followed detected by TRUST and TPPA. All patients were diagnosed according to the Syphilis Diagnostic Criteria. The diagnostic accuracy of the three test methods and the diagnostic value of the combined test were compared. Results The diagnostic accuracy of ELISA and TPPA( 93. 38% and 95. 82 respectively) for suspected syphilis was significantly higher than the TRUST method( 84. 32%),P < 0. 05. The sensitivity of the three test methods for the syphilis diagnosis was between 68.97% and 94.83%,the specificity was between 94.74% and 96.49%,and the Yoden index was between 0. 637 and 0. 913. On the basis of ELISA screening,the sensitivity,specificity and Yoden index were 98.28%,94.74% and 0.930 respectively in the combined detection of TRUST and TPPA. Conclusions The diagnostic rate of ELISA and TPPA for suspected syphilis was relatively high,and the diagnostic value of combined detection of the three methods was high. The patients of suspected syphili could be screened by ELISA,and then detected by combined detection of TRUST and TPPA,in order to improve the clinical value in diagnosing syphilis diagnosis.
Objective To explore the clinical value of enzyme-linked immunosorbent assay( ELISA),tolulized red unheated serum test( TRUST),treponema pallidum particle assay( TPPA) and combined detection of them for treponema pallidum antibodies. Methods 287 patients of suspected syphilis,visit our hospital for examination during January 2015 and December 2017,were selected as study subjects. They were screened for TP antibody by ELISA,followed detected by TRUST and TPPA. All patients were diagnosed according to the Syphilis Diagnostic Criteria. The diagnostic accuracy of the three test methods and the diagnostic value of the combined test were compared. Results The diagnostic accuracy of ELISA and TPPA( 93. 38% and 95. 82 respectively) for suspected syphilis was significantly higher than the TRUST method( 84. 32%),P < 0. 05. The sensitivity of the three test methods for the syphilis diagnosis was between 68.97% and 94.83%,the specificity was between 94.74% and 96.49%,and the Yoden index was between 0. 637 and 0. 913. On the basis of ELISA screening,the sensitivity,specificity and Yoden index were 98.28%,94.74% and 0.930 respectively in the combined detection of TRUST and TPPA. Conclusions The diagnostic rate of ELISA and TPPA for suspected syphilis was relatively high,and the diagnostic value of combined detection of the three methods was high. The patients of suspected syphili could be screened by ELISA,and then detected by combined detection of TRUST and TPPA,in order to improve the clinical value in diagnosing syphilis diagnosis.
引文
[1]吴昊.酶联免疫吸附法与甲苯胺红不加热血清试验在梅毒检验中诊断价值的比较[J].国际检验医学杂志,2017,38(23):3298-3302.
[2]张瑞芳,高丽华,董宇青,等.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.
[3]中华人民共和国卫生与计划生育委员会.WS 273-2007梅毒诊断标准[M].北京:人民卫生出版社,2007.
[4] Bu sse C,Navid MH,Strubel A,et al. Evaluation of a new recombinant antigen-based Virotech Treponema pallidum screen ELISA for diagnosis of syphilis[J].Clin Lab,2013,59(5-6):523-529.
[5] Liu C,Ou Q,Chen H,et al.The diagnostic value and performance evaluation of five serological tests for the detection of Treponema pallidum[J].J Clin Lab Anal,2014,28(3):204-209.
[6]喻甫国.ELISA法梅毒抗体检测与TRUST试验在梅毒诊断中的应用价值[J].现代中西医结合杂志,2015,24(16):1798-1799.
[7]马晓莉.ELISA、TRUST法行梅毒血清学检测效果比较[J].山东医药,2015,55(38):62-63.
[8]孙红,朱安友,郭普,等.TP-ELISA、TRUST和TPPA联合检测在梅毒诊断中的应用[J].蚌埠医学院学报,2015,40(10):1392-1394.
[9]何思杰,黄翠芳,冼洁能,等.TPPA、TP-ELISA和TRUST检测梅毒临床价值对比研究[J].中国医学创新,2017,14(18):59-62.
[10]韩红星,李小勇,李冉冉,等.TRUST和TPPA联合检测梅毒的临床应用价值[J].海南医学,2017,28(12):2044-2045.
[2]张瑞芳,高丽华,董宇青,等.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.
[3]中华人民共和国卫生与计划生育委员会.WS 273-2007梅毒诊断标准[M].北京:人民卫生出版社,2007.
[4] Bu sse C,Navid MH,Strubel A,et al. Evaluation of a new recombinant antigen-based Virotech Treponema pallidum screen ELISA for diagnosis of syphilis[J].Clin Lab,2013,59(5-6):523-529.
[5] Liu C,Ou Q,Chen H,et al.The diagnostic value and performance evaluation of five serological tests for the detection of Treponema pallidum[J].J Clin Lab Anal,2014,28(3):204-209.
[6]喻甫国.ELISA法梅毒抗体检测与TRUST试验在梅毒诊断中的应用价值[J].现代中西医结合杂志,2015,24(16):1798-1799.
[7]马晓莉.ELISA、TRUST法行梅毒血清学检测效果比较[J].山东医药,2015,55(38):62-63.
[8]孙红,朱安友,郭普,等.TP-ELISA、TRUST和TPPA联合检测在梅毒诊断中的应用[J].蚌埠医学院学报,2015,40(10):1392-1394.
[9]何思杰,黄翠芳,冼洁能,等.TPPA、TP-ELISA和TRUST检测梅毒临床价值对比研究[J].中国医学创新,2017,14(18):59-62.
[10]韩红星,李小勇,李冉冉,等.TRUST和TPPA联合检测梅毒的临床应用价值[J].海南医学,2017,28(12):2044-2045.