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目的以梅毒螺旋体明胶凝集试验(TPPA)为标准,比较临床常用的检测梅毒的两种血清学方法的优劣性。方法用非特异性的甲苯胺红不加热血清试验(TRUST)、酶联免疫吸附试验(ELISA)方法对883名性病门诊患者进行梅毒筛检,阳性标本用梅毒确证试验(TPPA)法进行确证。结果 TRUST法灵敏度为71.01%(245/345),假阳性率8.92%(24/269),漏检率28.99%(100/345);ELISA法灵敏度为99.42%(343/345),假阳性率0.58%(2/345),漏检率为0.58(2/345)。与TRUST相比,ELISA法检测敏感度(χ2=110.49,P<0.01)、假阳性率(χ2=25.94,P<0.01)以及漏检率均有明显差异(χ2=110.49,P<0.01)。结论 ELISA法具有较高的灵敏度和特异性,漏检率较低,适合用于性病门诊梅毒筛查。
Objective To compare the advantages and disadvantages of two serological methods for detecting syphilis, which is commonly used in clinical practice, with Treponema pallidum gelatin agglutination test (TPPA) as the standard. Methods Totally 883 STD clinics were screened for syphilis using non-specific TRUST and ELISA methods. The positive samples were confirmed by the syphilis confirmed test (TPPA). Results The sensitivity of TRUST was 71.01% (245/345), the false positive rate was 8.92% (24/269), the false negative rate was 28.99% (100/345). The sensitivity of ELISA was 99.42% (343/345) 0.58% (2/345), miss detection rate of 0.58 (2/345). Compared with TRUST, the sensitivity of ELISA (χ2 = 110.49, P <0.01), the false positive rate (χ2 = 25.94, P <0.01) and the undetected rate were significantly different (χ2 = 110.49, P <0.01). Conclusion ELISA method has high sensitivity and specificity, low detection rate, suitable for STD clinic syphilis screening.