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目的结合患者临床资料,比较快速血浆反应素环状卡片试验(RPR)、梅毒螺旋体特异性抗体化学发光法(CLIA)和梅毒螺旋体明胶颗粒凝集试验(TPPA)检测梅毒的优缺点。方法 1 808例标本分别采用RPR法和CLIA法检测,结果阳性的标本再用TPPA法复测。结果1 808例患者中共确诊170例梅毒感染患者。RPR法敏感性和阳性预测值较低,与CLIA法和TPPA法相比差异有统计学意义(P<0.05);RPR法特异性与CLIA法相比差异无统计学意义(P>0.05);阴性预测值低于CLIA法,差异有统计学意义(P<0.05)。CLIA法敏感性与TPPA法相比差异无统计学意义(P>0.05),阳性预测值低于TPPA法,差异有统计学意义(P<0.05)。三种方法均存在一定的生物学假阳性,RPR法和TPPA法存在一定的假阴性。结论梅毒血清学试验CLIA法和TPPA法在梅毒诊断方面优于RPR法,建议改进梅毒检测流程并且结合流行病史、临床资料及实验室检查结果综合判断。
Objective To evaluate the advantages and disadvantages of syphilis by combining clinical data of patients, rapid plasma cardioprotective cyclic card assay (RPR), CLIA with Treponema pallidum and TPPA. Method 1 808 specimens were detected by RPR method and CLIA method, the results of positive specimens retest by TPPA method. Results A total of 1 808 patients were diagnosed in 170 cases of syphilis infection. The sensitivity and positive predictive value of RPR method were lower than those of CLIA method and TPPA method (P <0.05). The specificity of RPR method was not significantly different from that of CLIA method (P> 0.05) Value was lower than CLIA method, the difference was statistically significant (P <0.05). There was no significant difference between the sensitivity of CLIA method and TPPA method (P> 0.05). The positive predictive value was lower than that of TPPA method (P <0.05). There are some biological false positives in the three methods. There are some false negatives in RPR and TPPA methods. Conclusion Syphilis serological tests CLIA method and TPPA method in the diagnosis of syphilis is superior to the RPR method, it is recommended to improve the syphilis detection process and combined with epidemiological history, clinical data and laboratory test results to determine.