两种检测在梅毒血清学检查中应用.docVIP

两种检测在梅毒血清学检查中应用 　　摘要:[目的] 探讨合理选择特殊人群梅毒血清学筛查的有效方法,提高筛查敏感性和特异性,准确运用其结果反映梅毒流行情况,评估流行趋势。 　　[方法] 同时采用TPPA、TRUST两种检测方法对被行政拘留的卖淫女进行连续的梅毒血清学监测。 　　[结果] 共监测581例,TPPA阳性119例,阳性率为20.48%;TRUST阳性55例,阳性率为9.46%;TRUST阳性率仅为TPPA的46.21%。 　　[结论] 梅毒筛查方法,尤其是特殊人群、供血人员及哨点血清学监测,宜以TPPA进行筛查,阳性结果再进行TRUST/RPR定性、定量检测,以明确活动状况,可以有效地降低漏诊,更全面、准确地反映梅毒感染状况,评估流行趋势。 　　关键词: 梅毒; 血清学筛查; 梅毒螺旋体颗粒凝集抗体试验; 甲苯红不加热血清反应素试验; 特殊人群 中图分类号:R 7 文献标志码: B 　　 　　Application of two breadboard methods in serologial screening of syphilis 　　WANG Hong-jun, WANG Xiao-ju, XU Hai-ying (Zhangjiagang Center for Disease Control and Prevention, Jiangsu 215600, China) 　　Abstract:[Objective] To explore effective methods to increase the sensitivity and specificity in the serology screening of syphilis among specialized population. The results will also be benefitial to evaluate the trend of epidemic of syphilis. 　　[Methods] Continuous serological screening of syphilis among prostitudes by using TPPA together with TRUST methods. 　　[Results] Among 581 cases, the cases positive in TPPA and TRUST were 119 and 55 and the positive rates were 20.48% and 9.46% respectively. The positive rate of TRUST was only 46.21% of that of TPPA. 　　[Conclusion] TPPA can be applied in screening of syphilis serologicall especially among the special population, blood-doners and in fixed places for serology monitoring. TRUST/RPR can be applied in the positive cases of TPPA in order to diagnose syphilis qualitatively and quantitatively, so as to identify syphilis in various periods, reduce missed diagnosis and evaluate the epidemic of syphilis. 　　Key words: Syphilis; Screening of serology; TPPA; TRUST; Special population 　　 　　目前,梅毒血清学监测多采用非梅毒螺旋体抗原试验进行筛查,如甲苯胺红不加热血清反应素试验(TRUST)阳性或可疑阳性标本再采用梅毒螺旋体抗原试验,如梅毒螺旋体颗粒凝集抗体试验(TPPA)进行确证。非梅毒???旋体抗原试验不适合于检测潜伏期、早期及晚期梅毒[1],而特殊人群的血清学监测对可疑者不易追踪复查,如果以此类试验作为梅毒血清学筛查的主要手段,可导致潜伏期、早期及晚期梅毒的漏诊。为了进一步探讨梅毒血清学筛查的有效方法,提高敏感性,降低漏诊,我们同时采用TPPA、TRUST对行政拘留的性罪错人员进行连续17个月的血清学监测,并就TPPA、TRUST在疫情监测及特殊人群的专题调查中的合理选用进行了讨论。现将结果报道如下。 　　 　　1 对象与方法