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。

Combination of two serological methods for syphilis detection

Objective To improve the syphilis screening rate of Enzyme-linked immunosorbent assay(ELISA) method and ensure the effectiveness of the syphilis serological detection.Method ELISA and toluidine red unheated serum test(TRUST) were used in combination for syphilis serological screening of 2 686 serum samples in Pudong New Area of Shanghai in 2011.The positive samples tested by the combined method were retested by Treponema pallidum particle agglutination(TPPA) to identify the biological false positive rate.Then 1 000 samples selected randomly from 2 397 samples which were tested negative by combined ELISA and TRUST were retested by TPPA to identify their biological false negative rate.Results The sensitivity of ELISA relative to TPPA was 98.9%,and the specificity was 98.4%.There was no significant difference between the ELISA and TPPA(P>0.05).The sensitivity of the combined ELISA and TRUST method was almost 100%,and the specificity was 98.3%.Conclusion The sensitivity of combined ELISA and TRUST method was almost 100%,indicating that the method can be used for syphilis serological screening,On the other hand,the specificity of the combined method was 98.3 %,with some false positive rate,indicating that the positive samples by the combined method(except for positive samples with the respective two methods) should be confirmed by TPPA.