TRUST、ELISA法检测梅毒的应用价值评价

目的 对临床常用的TRUST、ELISA梅毒检测法的应用价值进行评价.方法 同时用TP-PA、TRUST、ELISA法检测950位输血前检查患者和162位性病门诊患者的梅毒抗体,将TRUST、ELISA法的检测结果与TPPA法进行配对χ2检验并分别以TPPA法为"金标准"评价TRUST、ELISA法的敏感性、特异性、Youden指数、Kappa值等.结果 输血前检查组和性病门诊组TRUST法结果与TPPA法均有显著差异,ELISA法的结果TPPA法一致.输血前检查组TRUST的敏感性、特异性、Youden指数、Kappa值分别为57.1%、98.7%、0.56、0.33,ELISA法则分别为83.3%、99.7%、0.83、0.89;性病门诊组TRUST的敏感性、特异性、Youden指数、Kappa值分析为97.1%、86.7%、0.84、0.64,ELISA法则分别为99.2%、99.1%、0.93、0.94.结论 TRUST不适用于梅毒输血前检查,仅适宜于梅毒患者治疗效果的评价,ELISA在输血前和性病门诊梅毒检测中均有很高的敏感性和特异性,适用于输血前和性病患者的梅毒检测,尤其适用妹于大批量梅毒的检测.     

ELISA双抗原夹心法在梅毒检测中的重要分析

目的通过三种实验方法对梅毒进行检测.方法应用TEUST、SLISA和TPPA实验检测80例患者血液.结果80例ELISA法阳性TRUST法阴性标本中TPPA阳性为72例(90%),阴性为8例(10%).结论实验结果说明ELISA法对梅毒检测的检出率较高.     

3种不同梅毒抗体检测方法在临床中的应用价值

目的：比较3种不同梅毒血清学实验方法在临床中的应用价值。方法：应用甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶凝集试验（TPPA）、梅毒酶联免疫吸附试验（ELISA）检测血清标本中的梅毒螺旋体抗体。结果：TRUST、TPPA、ELISA的阳性率分别为86．67％、98．33％、98．89％。特异性分别为78．86％、96．57％、90.86％。同时发现ELISA检测时存在假阳性。结论：TRUST不适合作为梅毒的诊断。ELISA可作为输血和手术前检测的一种理想筛查方法。但对ELISA阳性标本应做TPPA检测，对ELISA检测阴性的标本则不需要TPPA确诊。     

Quantitative assessment of global cerebral metabolic rate of oxygen (CMRO2) in neonates using MRI

The cerebral metabolic rate of oxygen (CMRO₂) is the rate of oxygen consumption by the brain, and is thought to be a direct index of energy homeostasis and brain health. However, in vivo measurement of CMRO₂ is challenging, in particular for the neonatal population, in whom conventional radiotracer methods are not applicable because of safety concerns. In this study, we propose a method to quantify global CMRO₂ in neonates based on arteriovenous differences in oxygen content, and employ separate measurements of oxygenation and cerebral blood flow (CBF) parameters. Specifically, arterial and venous oxygenation levels were determined with pulse oximetry and the novel T₂ relaxation under spin tagging (TRUST) MRI, respectively. Global CBF was measured with phase contrast (PC) flow velocity MRI. The proposed method was implemented on a standard 3‐T MRI scanner without the need for any exogenous tracers, and the total scan duration was less than 5 min. We demonstrated the feasibility of this method in 12 healthy neonates within an age range of 35–42 gestational weeks. CMRO₂ values were successfully obtained from 10 neonates. It was found that the average CMRO₂ in this age range was 38.3 ± 17.7 µmol/100 g/min and was positively correlated with age (p = 0.007; slope, 5.2 µmol/100 g/min per week), although the highest CMRO₂ value in this age range was still less than half of the adult level. Test–retest studies showed a coefficient of variation of 5.8 ± 2.2% between repeated CMRO₂ measurements. In addition, given the highly variable blood flow velocity within this age range, it is recommended that the TRUST labeling thickness and position should be determined on a subject‐by‐subject basis, and an automatic algorithm was developed for this purpose. Although this method provides a global CMRO₂ measure only, the clinical significance of an energy consumption marker and the convenience of this technique may make it a useful tool in the functional assessment of the neonatal population. Copyright © 2014 John Wiley & Sons, Ltd.     

梅毒螺旋体抗体筛查及其临床意义

目的研究梅毒螺旋体的感染状况，探讨梅毒螺旋体抗体筛查的现实意义。方法采用酶联免疫分析法（ELIsA）检测梅毒螺旋体抗体，阳性者再使用甲苯胺红不加热血清试验（TRusT）和梅毒螺旋体明胶凝集试验（TPPA）做进一步检测。结果5998例住院患者ELISA法共检测出阳性86例，TPPA法检测出阳性78例，TRUST法检测出阳性22例。高龄（〉70岁）患者的阳性检出率高于其它年龄组。结论住院患者常规筛查梅毒螺旋体抗体可有效检测出隐性梅毒患者，不仅可以早诊断、早治疗，减少医疗纠纷的发生，也可以预防院内交叉感染。     

Evaluation of three automated Treponema pallidum antibody assays for syphilis screening

The accuracy of the test is critical for the syphilis serology diagnosis. This study aims to evaluate the values of the Elecsys syphilis assay, the Architect syphilis assay, and the Mindray syphilis assay, as syphilis screening tests for pregnant women and patients with syphilis or other diseases. A reverse algorithm was used for the syphilis serology diagnosis. Serum samples (n = 584) were tested with three automated screening assays. All reactive sera by one, two, or three screening assays were further analyzed with the tolulized red unheated serum test (TRUST). Inconsistent results were confirmed by the Treponema pallidum particle agglutination assay (TPPA). The final patient diagnosis was made according to the results of syphilis serology, clinical evidence, and past medical history. The sensitivity, specificity, accuracy, and kappa value of each assay were as follows: for the Elecsys syphilis assay, 100.0%, 98.5%, 98.6%, and 0.927, respectively; for the Architect syphilis assay: 100.0%, 94.5%, 95.0%, and 0.770; and for the Mindray syphilis assay: 100.0%, 97.0%, 97.3%, and 0.862. The McNemar test showed that there were significant differences in the performance between the Elecsys syphilis assay and the Architect syphilis assay (P < 0.001), and between the Mindray syphilis assay and the Architect syphilis assay (P = 0.001). Our study demonstrated that three automated Treponema pallidum antibody assays generally showed high sensitivities and specificities, and so, they are suitable for use in screening for syphilis. The performances of the Elecsys syphilis assay and the Mindray syphilis assay are superior to Architect syphilis assay.     

比较三种梅毒检测方法

目的：对TP－ELISA,TP－PA,TRUST3种梅毒检测方法进行比较,根据各试验的优点和不足,选择一种常规梅毒筛查的理想方法。方法以TP－ELISA,TPPA,TRUST同时检测样本2115例。结果 ELISA阳性者80例,检出率3．8％（80／2115）,TP－ELISA阳性同时TPPA阳性77例,符合率96．2％（77／80）,TP－ELISA阳性, TPPA阴性3例,假阳性率为3．75％（3／80）。TRUST阳性20例,符合率25％（20／80）,TRUST阴性60例,占75％（60／80）。3例ELISA阳性TPPA阴性的TRUST检测结果均为阴性。结论 TP－ELISA可作为梅毒筛查的理想方法。     

两种梅毒血清学检测方法的联合运用分析

目的进一步提高酶联免疫吸附试验(ELISA)对梅毒的筛查率,确保梅毒血清学的检测效果。方法采用ELISA联合甲苯胺红不加热血清试验(TRUST),对2011年上海浦东新区2 686例监测人群的血清样本进行梅毒血清学筛查,联合检测的血清学阳性样本用梅毒螺旋体明胶凝集试验(TPPA)甄别其生物学假阳性;再从2 397份两种方法均为阴性的样本中,随机抽取1 000份进行TPPA检测,甄别其生物学假阴性。结果 ELISA法相对于TPPA法的敏感性为98.9%,特异性为98.4%,两法间差异无统计学意义(P>0.05);ELISA与TRUST法联合应用后的敏感性接近100%,特异性为98.3%。结论 ELISA与TRUST方法的联合应用,其敏感性接近100%,表明其可用于梅毒筛查;另一方面,两者联合运用的特异性为98.3%,具有一定的假阳性率,表明其阳性样本(两法均为阳性的样本除外)还需应用TPPA方法进行最终确认。     

梅毒螺旋体感染四种血清学检测方法的临床评价

目的探讨四种梅毒血清学实验诊断方法的准确性及在临床的应用价值。方法应用甲苯胺红不加热血清学试验（TRUST）、酶联免疫吸附试验（ELISA）和胶体金法检测518例性病科患者血清,并用梅毒螺旋体明胶颗粒凝集试验（TPPA）确认。结果 TRUST法灵敏度为58.18%,ELI SA法为99.37%、胶体金法为99.06%;TRUST法特异度为88.5%,ELI SA法为98.50%、胶体金法为100%。结论梅毒检测方法各有优缺点,应根据检验目的合理选用不同的试验方法。     

献血者梅毒ELISA和TRUST检测的评价

目的比较酶联免疫吸附试验（ELISA）和甲苯胺红不加热血清试验（TRUST）诊断梅毒的可靠性。方法分别平行使用TP—ELISA和TRUST（或TP—EuSA）筛查无偿献血者，任何一种试剂检测出阳性标本，均用TP明胶凝集试验（TPPA）确诊，比较ELISA和TRUST及TPPA之间敏感性的差异，计算不同方法假阳性和阴性比率。结果总共检测94770例无偿献血者，其中第一批47803名献血者分别用TP—ELISA和TRUST检测，第二批46967名献血者分别用两个厂家TP—ELISA检测，结果第一批标本检出阳性242份，其中TRUST和TP—ELISA阳性率分别为0．18％（87／47803）、0．49％（233／47803）．第二批标本检出阳性284份，两个厂家TP—ELISA阳性率分别为0.57％（269／46967）、0．55％（260／46967），TP—ELISA敏感性明显超过TPPA和TRUST（P〈0．01），国内两个厂家TP—ELISA无显著性差异（P〉0．05），若以TPPA为确认试验，TP—ELISA敏感性明显超过TRUST，TRUST假阴性高达59.5％，TP—ELISA假阴性仅有0％～2．7％，假阳性率0．06％～0．1％，灵敏度97．3％～100％。结论TRUST敏感性低，为提高TP筛查的敏感性，对献血者梅毒初检和复检，或者临床梅毒的筛查时，应应用TP—ELISA。