目的评估肥达试验、Tubex法在伤寒、甲型副伤寒诊断中的应用价值。方法采集广西、新疆、云南等地区伤寒及甲型副伤寒暴发疫情中的确诊病例血清,运用肥达试验及Tubex-TF、Tubex-PA进行伤寒及甲型副伤寒血清抗体检测,分别计算这3种血清学检测结果的灵敏度、特异度、假阳性率、假阴性率、约登指数和Kappa值等指标,对诊断结果进行评估。结果以血培养为金标准,对23例血培养阳性的伤寒血清进行检测,Tubex-TF方法的灵敏度为82.61%,特异度为61.64%,阳性预测值为0.404,阴性预测值为0.918;Tubex-PA对伤寒病例的非特异性阳性检出率为91.30%。71例血培养阳性的甲型副伤寒检测结果显示,Tubex-PA方法的灵敏度为74.65%,特异度为16.00%,阳性预测值为0.716,阴性预测值为0.182;Tubex-TF对甲型副伤寒病例的非特异性检测阳性率为39.44%。Tubex-TF/PA联合对伤寒及甲型副伤寒病例的总检出率为80.21%。在不同病程中,血培养阳性的伤寒及甲型副伤寒病例血清进行肥达试验,阳性率均低于6.00%,明显低于Tubex法的检出率(χ~2=75.165,P=0.000)。结论疾病暴发流行时,除了肥达试验,Tubex-TF方法可用以辅助诊断伤寒,有利于该疾病早期发现、诊断及治疗,而对于甲型副伤寒的辅助诊断仍有待进一步研究。 Objective To evaluate the application value of Wadda test and Tubex method in the diagnosis of typhoid fever and paratyphoid fever. Methods Serum samples from typhoid fever and paratyphoid outbreaks in Guangxi, Xinjiang and Yunnan were collected. The serum levels of antibodies against typhoid fever and paratyphoid fever were detected by using the uptake test, Tubex-TF and Tubex-PA, respectively The sensitivity, specificity, false positive rate, false negative rate, Youden index and Kappa value of serological test results were used to evaluate the diagnostic results. The results of blood culture as the gold standard 23 cases of blood culture positive typhoid serum detection, Tubex-TF method was 82.61% sensitivity, specificity was 61.64%, the positive predictive value was 0.404, the negative predictive value was 0.918; Tubex- PA typhoid cases non-specific positive detection rate of 91.30%. The results of 71 blood group A-positive Paratyphus A tests showed that the sensitivity of Tubex-PA method was 74.65%, the specificity was 16.00%, the positive predictive value was 0.716 and the negative predictive value was 0.182. Tubex- Non-specific detection of cases the positive rate was 39.44%. The total detection rate of Tubex-TF / PA combined with typhoid and paratyphoid A was 80.21%. In different course of disease, blood culture-positive typhoid fever and paratyphoid A patients were tested for fat-test, the positive rate was less than 6.00%, which was significantly lower than that of Tubex method (χ ~ 2 = 75.165, P = 0.000) . Conclusion In addition to the Wadda test, the Tubex-TF method can be used to diagnose typhoid fever in early stage of disease outbreak, which is beneficial to the early detection, diagnosis and treatment of the disease. However, the auxiliary diagnosis of paratyphoid A remains to be further studied.