發(fā)布時間：2018-03-25 12:16

  本文選題：梅毒　切入點(diǎn)：實(shí)驗(yàn)室　出處：《中國皮膚性病學(xué)雜志》2017年05期

【摘要】：目的比較不同梅毒檢測方法診斷的準(zhǔn)確性,為梅毒篩查和診斷提供依據(jù)。方法 23 762例血清標(biāo)本采用微粒子化學(xué)發(fā)光免疫分析法(CMIA)和甲苯胺紅不加熱血清試驗(yàn)(TRUST)聯(lián)合檢測,陽性標(biāo)本再用梅毒螺旋體明膠顆粒凝集試驗(yàn)(TP-PA)復(fù)檢,同時對CMIA法檢測S/CO值0.50~0.99的陰性血清標(biāo)本也用TP-PA法復(fù)檢。CMIA與TP-PA法檢測結(jié)果不一致的血清標(biāo)本用免疫印跡法(WB)進(jìn)行確認(rèn)。結(jié)果 CMIA法聯(lián)合TRUST法檢出1 108例陽性標(biāo)本(4.66%),其中TRUST法陽性者486例(2.05%),CMIA法陽性者1 074例(4.52%),CMIA法(+)并TRUST法(+)者452例,TP-PA法復(fù)檢陽性率100%。CMIA法(+)/TRUST法(-)者622例,TP-PA法復(fù)檢陽性率92.12%;CMIA法(-)/TRUST法(+)者34例,TP-PA法復(fù)檢陽性率0。CMIA法(-)者的S/CO值0.50~0.99時TP-PA法復(fù)檢陽性率23.08%,S/CO值1.00~9.99時TP-PA法復(fù)檢陽性率88.14%,且S/CO值越大,TP-PA法復(fù)檢陽性率越高,S/CO值≥10.00時TP-PA法復(fù)檢陽性率100%。WB法對61例CMIA法和TP-PA法不一致標(biāo)本確證結(jié)果顯示:CMIA法陽性預(yù)測值(PPV)為57.14%,TP-PA法陽性預(yù)測值為16.67%,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論血清梅毒篩查檢驗(yàn)方法的敏感性:CMIA法TP-PA法TRUST法。CMIA法自動化程度高,結(jié)果易保留,為梅毒特異性抗體篩查的首選方法。CMIA法檢測陽性的標(biāo)本需進(jìn)一步作TRUST及其滴度試驗(yàn),而CMIA法陰性的標(biāo)本不必作TRUST試驗(yàn),以避免TRUST試驗(yàn)假陽性結(jié)果誤導(dǎo)臨床診療。CMIA法檢測S/CO值處于臨界值附近時,臨床醫(yī)生應(yīng)結(jié)合患者臨床資料進(jìn)行綜合診斷,對疑似病例進(jìn)行隨訪和復(fù)檢。
[Abstract]:Objective to compare the diagnostic accuracy of different syphilis detection methods in order to provide evidence for the screening and diagnosis of syphilis. Methods 23 762 serum samples were detected by CMIA (microparticle chemiluminescence immunoassay) and trust test (toluidine red unheated serum test). The positive specimens were reexamined with the gelatin particle agglutination test of Treponema pallidum. At the same time, the negative serum samples whose S/CO value was 0.50 ~ 0.99 detected by CMIA method were also confirmed by TP-PA. CMIA and TP-PA methods. Results 1 108 positive samples were detected by CMIA method combined with TRUST method. Of these, 1 074 cases were positive by TRUST method and 452 cases by TRUST method and 4 074 cases were positive by TP-PA method. 622 cases were diagnosed by TP-PA method. The positive rate of TP-PA method was 92.12CMIA method and TP-PA method was used in 34 cases. 0.CMIA method was used to recheck the positive rate of TP-PA method in 34 cases of patients with TP-PA method and TP-PA method. (2) the positive rate of TP-PA method was 92. 12% by TP-PA method. (2) the positive rate of TP-PA method was 92. 12% by TP-PA method. (2) the positive rate of TP-PA method was 92. 12% by TP-PA method. When S/CO value was 0.50 ~ 0.99, the positive rate of TP-PA method was 23.08 and the positive rate of TP-PA method was 88.14 when S / P CO value was 1.00 ~ 9.99, and the higher the S/CO value was, the higher the positive rate of TP-PA method was, and the higher the positive rate of TP-PA method was, the higher the S/CO value was, the higher the TP-PA method was when the S/CO value was 鈮，

本文編號：1663085