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目的探讨酶联免疫吸附试验(TP-ELISA)、梅毒螺旋体明胶试验(TPPA)和甲苯胺红不加热血清学试验(TRUST)三种梅毒血清学检测方法在孕妇梅毒筛查中的应用。方法对2012年3月~2014年3月间就诊的24 964例孕妇同时采用ELISA、TPPA和TRUST等方法进行血清学检测,对检测结果进行分析。结果 24 964例孕妇标本中ELI-SA阳性180例,TPPA阳性178例,TRUST阳性74例。新感染患者74例,既往感染的患者104例,患者阳性率为0.71%;TPPA和ELISA检测结果比较差异无统计学意义(P=0.754,κ=0.972),在45例一期梅毒患者中,阳性符合率为97.78%,23例二期梅毒患者阳性符合率为95.65%,在6例三期梅毒患者中,阳性符合率为100.00%;TPPA和TRUST检测结果有显著性差异(P<0.001,κ=0.476),在一期梅毒中的阳性符合率为71.11%,在二期梅毒中的阳性符合率为100.00%,在三期梅毒中的阳性符合率为66.67%。结论对于孕妇梅毒筛查,可先用ELISA方法进行筛查,提高初检结果的检出率,阳性结果通过TPPA确诊,用TRUST试验观察疗效、判断预后。
Objective To investigate the application of TP-ELISA, TPPA and TRUST serological tests in pregnant women with syphilis screening. Methods A total of 24 964 pregnant women who visited between March 2012 and March 2014 were tested for serology by ELISA, TPPA and TRUST, and the results were analyzed. Results Among 24 964 pregnant women, ELI-SA was positive in 180 cases, TPPA was positive in 178 cases and TRUST was positive in 74 cases. 74 cases were newly infected and 104 cases were previously infected, the positive rate was 0.71%. There was no significant difference between TPPA and ELISA (P = 0.754, κ = 0.972). Among the 45 patients with primary syphilis, The positive coincidence rate was 97.78%. The positive coincidence rate was 95.65% in 23 cases of second stage syphilis, and the positive coincidence rate was 100.00% in 6 cases of third stage syphilis. There was significant difference between TPPA and TRUST (P <0.001, κ = 0.476), the positive coincidence rate in first stage syphilis was 71.11%, the positive coincidence rate in second stage syphilis was 100.00%, and the positive coincidence rate in third stage syphilis was 66.67%. Conclusion For pregnant women screening of syphilis, ELISA method can be used to screen and improve the detection rate of primary examination results. The positive results are confirmed by TPPA. TRUST test is used to observe the curative effect and prognosis.