摘要
目的探讨甲苯胺红不加热试验(TRUST)、梅毒螺旋体抗体凝集法(TPPA)、化学发光微粒子免疫检测法(CMIA)检测梅毒的效能评价,及三项试验联合检测的阳性符合率,验证梅毒传统筛查流程的临床应用。方法收集广州医科大学附属第二医院实验室梅毒筛查试验TRUST、TPPA任一检测结果阳性患者的血清标本,采用CMIA法复检,再通过免疫印迹法(Western blot,WB)(TP-IgG)进行确证复核,分析各阳性组合模式的筛查结果。结果经WB法确证后,灵敏度由高至低依次为CMIA(94.29%)、TPPA(88.57%)、TRUST(25.71%)。联合TRUST、TPPA和CMIA三项试验对阳性血清样本得到6种阳性组合模式,通过WB进行确证复核,CMIA(+)TPPA(+)TRUST(+)(85.71%)和CMIA(+)TPPA(+)TRUST(-)(75.76%)阳性符合率较高。结论TRUST、TPPA和CMIA三种血清学试验中CMIA法灵敏度较高。传统梅毒两项筛查(即TPPA与TRUST联合)模式存在一定的漏诊率和误诊率,建议联合CMIA法来提高诊断效能,当三项联合试验结果不一致时应通过Western blot法确证。
Objective To discuss the diagnostic performance of toluidine red unheated serum test(TRUST),Treponema pallidum particle assay(TPPA)and chemiluminescence microparticle immunoassay(CMIA)for syphilis,the positive coincidence rate of the combination of TRUST+TPPA+CMIA,and evaluate the clinical application of traditional syphilis screening process.Methods Serum samples were collected from the patients with positive syphilis diagnosed by TPPA,TRUST at Second Affiliated Hospital of Guangzhou Medical University clinical laboratory.The samples were re-tested with CMIA and confirmed with Western blot(TP-IgG).Results The sensitivities of the screening methods from high to low were CMIA(94.29%),TPPA(88.57%)and TRUST(25.71%).Six positive combination models were obtained from positive serum samples by combined TRUST,TPPA and CMIA tests.CMIA(+)TPPA(+)TRUST(+)(85.71%)and CMIA(+)TPPA(+)TRUST(-)(75.76%)had the higher positive coincidence rate confirmed and verified by WB.Conclusions Among the three serological tests of TRUST,TPPA and CMIA,the CMIA method had higher sensitivity.The traditional syphilis two-screening mode(TPPA and TRUST combined)had a certain rate of misdiagnosis.It was recommended to combine the CMIA method to improve the diagnostic efficiency.When the results of the three combined tests were inconsistent,the Western blot method should be used for confirmation.
作者
朱逸文
邓小燕
ZHU Yi⁃wen;DENG Xiao⁃yan(Aviation Medical Department,China Southern Airlines Company Limited,Guangzhou,Guangdong 510406;King Med School of Laboratory Medicine,Guangzhou Medical University,Guangzhou,Guangdong 510180;The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510260,China)
出处
《热带医学杂志》
CAS
2022年第4期525-528,共4页
Journal of Tropical Medicine
