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目的探讨引起梅毒特异性抗体检测的假阳性结果可能的原因。为临床治疗梅毒提供更有价值的试验依据。方法收集我院2005年1月-2008年4月9 456例门诊病人的血清标本,采用TRUST法测定梅毒血清非特异性脂类抗原。TPPA法和ELISA法测定血清梅毒螺旋体特异性抗体。结果受检的9 456人次中经TPPA确证的梅毒540例,检出率5.71%。540例确诊的梅毒中TRUST法318例阳性,敏感性58.9%。42例经TPPA法确证为阴性,特异性88.3%。ELISA法538例阳性,敏感性99.6%。3例经TPPA确诊为阴性,特异性99.4%。TPPA法检出梅毒的阳性率与ELISA法差异无显著性(χ2=0.2,P>0.05),但明显高于TRUST法(χ2=222,P<0.05),差异性显著。结论TRUST法和ELISA法联合检测结合病史,体检结果及其他检测结果综合分析后作出诊断,才能避免造成误诊。
Objective To investigate the possible causes of false positive results of syphilis-specific antibodies. For the clinical treatment of syphilis provide more valuable experimental basis. Methods Serum samples from 9,556 outpatients in our hospital from January 2005 to April 2008 were collected, and TRUST was used to determine the serum nonspecific lipids of syphilis. Determination of Serum Treponema pallidum Specific Antibodies by TPPA and ELISA. Results Among the 9 456 subjects examined, 540 cases of TPPA-confirmed syphilis had a detection rate of 5.71%. Among 540 confirmed cases of syphilis, TRUST was positive in 318 cases with a sensitivity of 58.9%. Forty-two patients were confirmed as negative by TPPA and the specificity was 88.3%. 538 cases of ELISA positive, sensitivity 99.6%. Three cases were negative by TPPA, the specificity of 99.4%. The positive rate of syphilis detected by TPPA was not significantly different from ELISA (χ2 = 0.2, P> 0.05), but significantly higher than TRUST (χ2 = 222, P <0.05). Conclusion TRUST and ELISA combined with medical history, physical examination results and other test results after a comprehensive analysis of the diagnosis, to avoid misdiagnosis.