不同梅毒筛查方法效果比较

发布时间：2018-03-25 12:16

  本文选题：梅毒　切入点：实验室　出处：《中国皮肤性病学杂志》2017年05期

【摘要】：目的比较不同梅毒检测方法诊断的准确性,为梅毒筛查和诊断提供依据。方法 23 762例血清标本采用微粒子化学发光免疫分析法(CMIA)和甲苯胺红不加热血清试验(TRUST)联合检测,阳性标本再用梅毒螺旋体明胶颗粒凝集试验(TP-PA)复检,同时对CMIA法检测S/CO值0.50~0.99的阴性血清标本也用TP-PA法复检。CMIA与TP-PA法检测结果不一致的血清标本用免疫印迹法(WB)进行确认。结果 CMIA法联合TRUST法检出1 108例阳性标本(4.66%),其中TRUST法阳性者486例(2.05%),CMIA法阳性者1 074例(4.52%),CMIA法(+)并TRUST法(+)者452例,TP-PA法复检阳性率100%。CMIA法(+)/TRUST法(-)者622例,TP-PA法复检阳性率92.12%;CMIA法(-)/TRUST法(+)者34例,TP-PA法复检阳性率0。CMIA法(-)者的S/CO值0.50~0.99时TP-PA法复检阳性率23.08%,S/CO值1.00~9.99时TP-PA法复检阳性率88.14%,且S/CO值越大,TP-PA法复检阳性率越高,S/CO值≥10.00时TP-PA法复检阳性率100%。WB法对61例CMIA法和TP-PA法不一致标本确证结果显示:CMIA法阳性预测值(PPV)为57.14%,TP-PA法阳性预测值为16.67%,差异有统计学意义(P0.05)。结论血清梅毒筛查检验方法的敏感性:CMIA法TP-PA法TRUST法。CMIA法自动化程度高,结果易保留,为梅毒特异性抗体筛查的首选方法。CMIA法检测阳性的标本需进一步作TRUST及其滴度试验,而CMIA法阴性的标本不必作TRUST试验,以避免TRUST试验假阳性结果误导临床诊疗。CMIA法检测S/CO值处于临界值附近时,临床医生应结合患者临床资料进行综合诊断,对疑似病例进行随访和复检。
[Abstract]:Objective to compare the diagnostic accuracy of different syphilis detection methods in order to provide evidence for the screening and diagnosis of syphilis. Methods 23 762 serum samples were detected by CMIA (microparticle chemiluminescence immunoassay) and trust test (toluidine red unheated serum test). The positive specimens were reexamined with the gelatin particle agglutination test of Treponema pallidum. At the same time, the negative serum samples whose S/CO value was 0.50 ~ 0.99 detected by CMIA method were also confirmed by TP-PA. CMIA and TP-PA methods. Results 1 108 positive samples were detected by CMIA method combined with TRUST method. Of these, 1 074 cases were positive by TRUST method and 452 cases by TRUST method and 4 074 cases were positive by TP-PA method. 622 cases were diagnosed by TP-PA method. The positive rate of TP-PA method was 92.12CMIA method and TP-PA method was used in 34 cases. 0.CMIA method was used to recheck the positive rate of TP-PA method in 34 cases of patients with TP-PA method and TP-PA method. (2) the positive rate of TP-PA method was 92. 12% by TP-PA method. (2) the positive rate of TP-PA method was 92. 12% by TP-PA method. (2) the positive rate of TP-PA method was 92. 12% by TP-PA method. When S/CO value was 0.50 ~ 0.99, the positive rate of TP-PA method was 23.08 and the positive rate of TP-PA method was 88.14 when S / P CO value was 1.00 ~ 9.99, and the higher the S/CO value was, the higher the positive rate of TP-PA method was, and the higher the positive rate of TP-PA method was, the higher the S/CO value was, the higher the TP-PA method was when the S/CO value was 鈮，

本文编号：1663085