摘要
目的 研究两种神经梅毒检测方法 [梅毒甲苯胺红不加热血清试验（TRUST）和梅毒螺旋体明胶凝集试验（TPPA）]的特异性、敏感性和关联性,进一步探讨两者对神经梅毒诊断和判断疗效的价值. 方法 采用TRUST和TPPA检测255例HIV阴性患者的血液和脑脊液标本,对确诊为神经梅毒的患者运用大剂量青霉素治疗,半年后复查血液和脑脊液TRUST和TPPA.比较两种检测方法 的敏感性、特异性、关联性以及半年后两种检测方法 的转阴率. 结果 255例患者中有103例确诊为神经梅毒.脑脊液TRUST检测神经梅毒的敏感性和特异性分别为78.64%、99.34%,脑脊液TPPA检测神经梅毒的敏感性和特异性均为100%,两种检测方法 检出阳性率比较差异有统计学意义（P＜0.05）.治疗半年后92例患者复查血液TRUST和血液TPPA,76例患者复查脑脊液TRUST和脑脊液TPP,发现脑脊液TRUST、脑脊液TPPA、血液TRUST、血液TPPA的转阴率分别为25%（15/60）、0（0/76）、1.87%（1/92）、0（0/92）,脑脊液TRUST转阴率较血液TRUST转阴率高,比较差异有统计学意义（P＜0.05）. 结论 脑脊液TPPA应作为神经梅毒的确诊病例标准,脑脊液TRUST可作为其疗效参考指标.
Objective To assess the specificity and sensitivity of syphilis toluidine red untreated serum test （TRUST） and treponema pallidum particle agglutination （TPPA）, and further explore their values in the diagnosis of neurosyphilis and the accuracy in determining the efficacy of treating neurosyphilis. Methods The serum and CSF samples of 255 HIV-negative patients were examined by TRUST and TPPA. Patients diagnosed as having neurosyphilis accepted treatment with large dose of Penicillin G and re-checked the blood and CSF with TRUST and TPPA halfyear later. Results One hundred and three patients were diagnosed as having neurosyphilis. The sensitivity and specificity indexes of TRUST in the CSF were 78.64% and 99.34%; those of TPPA measurement in the CSF 100% and 100%. The positive rate in detecting the neurosyphilis between these 2 measurements were significantly different （P＜0.05）. Ninety-two patients were followed up and serum-examined by TRUST and TPPA and 76 were re-checked the CSF by TRUST and TPPA halfyear later; TRUST and TPPA on the CSF turnedto negative results at a ratio of （25%,0）, and those on the blood （1.87% and 0）, respectively. The TRUST showed that negative ratio in the CSF was significantly higher than that in the blood after half year treatment （P＜0.05）. Conclusion Detection on the CSF with TPPA should be accepted to substitute VDRL as the best serological test in the diagnoses of neurosyphilis, and that on CSF with TRUST can be used as an index of evaluating the treatment.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2010年第8期841-843,共3页
Chinese Journal of Neuromedicine
