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目的了解本地区梅毒感染的流行病学情况,并对TRUST、TP-ELISA和TPPA三种检测梅毒螺旋体的方法进行临床应用评价,为预防和控制梅毒蔓延提供科学依据。方法对2006年1月～2008年12月前来本院就诊的5000份患者血清标本进行TRUST、TP-ELISA或TPPA梅毒螺旋体血清学检测,并结合流行病学史及临床表现,进行梅毒流行病学调查。随机抽取上述梅毒阳性患者血清样本120份与健康体检者血清样品130份,对每份标本同时进行TRUST、TP-ELISA和TPPA检测,评价其敏感性和特异性。结果2006～2008年度梅毒阳性率分别为2.9%,4.3%和7.7%;一期梅毒分别为57.9%、71.9%和62.3%,二期梅毒分别为32.6%、23.4%和30.3%,三期梅毒分别为1.8%、1.5%和2.0%,隐性梅毒分别为7.7%、3.2%和5.4%;梅毒患者中女性多于男性,男女比例为0.68:1,年龄分布主要在青壮年,文化程度主要以低素质为主,职业分布以服务业和打工者为主。TRUST、TP-ELISA和TPPA的敏感性分别为73.6%、89.5%和63.5%,特异性分别为89.4%、96.0%和100%。结论梅毒感染呈逐年上升趋势,防治措施亟待进一步加强。3种方法中TP-ELISA法敏感性最高,TPPA特异性最高。ELISA方法存在假阳性和假阴性结果,对于ELISA阳性的标本和在灰区的标本应做TPPA进行确认。而TRUST主要在判断患者病情和疗效方面有重要价值。
Objective To understand the prevalence of syphilis infection in this area and to evaluate the clinical application of TRUST, TP-ELISA and TPPA in the detection of Treponema pallidum and provide a scientific basis for preventing and controlling the spread of syphilis. Methods Serum specimens of 5000 patients with TRUST, TP-ELISA or TPPA were collected from January 2006 to December 2008 in our hospital and combined with the epidemiological and clinical manifestations of syphilis epidemics Learn to investigate. 120 serum samples of the above syphilis-positive patients and 130 serum samples of healthy subjects were randomly selected. TRUST, TP-ELISA and TPPA were tested simultaneously on each specimen to evaluate their sensitivity and specificity. Results The positive rates of syphilis between 2006 and 2008 were 2.9%, 4.3% and 7.7% respectively. The first stage syphilis was 57.9%, 71.9% and 62.3% respectively. The second stage syphilis was 32.6%, 23.4% and 30.3% respectively. Respectively, 1.8%, 1.5% and 2.0% respectively. The prevalence of latent syphilis was 7.7%, 3.2% and 5.4% respectively. There were more female patients than male patients in syphilis, with a male to female ratio of 0.68: 1. Mainly to low quality, occupational distribution to service workers and workers based. The sensitivity of TRUST, TP-ELISA and TPPA were 73.6%, 89.5% and 63.5% respectively, and the specificity was 89.4%, 96.0% and 100% respectively. Conclusions Syphilis infection shows an upward trend year by year, and prevention and control measures need to be further strengthened. Among the three methods, TP-ELISA had the highest sensitivity and the highest TPPA specificity. There was false-positive and false-negative results for the ELISA method, and TPPA was confirmed for ELISA-positive specimens and gray-zone specimens. TRUST has important value in judging patient’s condition and curative effect.