不同梅毒血清学诊断方法的临床检测与效果评价(1)
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[摘要]目的 探讨rTpN15-17-47-ELISA、RPR和TPPA三种用于梅毒血清抗体检测方法的敏感性和特异性。方法 三种方法分别检测50份无梅毒病史健康人血清、11例类风湿关节炎(RA)、5例肾病综合征(NS)及122例确诊梅毒患者血清标本中梅毒抗体，对各方法的检测结果进行比较。结果 rTpN15-17-47-ELISA对所有健康人血清、RA患者及NS患者血清检测结果均为阴性，对梅毒患者血清标本检测阳性率为97.5%，与TPPA(96.7%)相似(P>0.05)，且均高于RPR(80.3%)。结论 本研究中建立的以重组融合蛋白质rTpN15-17-47为抗原的ELISA有望成为高度敏感和特异的梅毒患者血清学筛查方法。
[关键词]梅毒螺旋体；rTpN15-17-47-ELISA；血清学诊断
[中图分类号] R446.5 [文献标识码] B [文章编号] 1673-9701(2011)24-133-02
Clinical Evaluation of Different Serological Methods for Diagnosis of Treponema Pallidum
WU Ying1 HU Yujie2 SUN Aihua2
1.Zeguo Branch of Taizhou Combination of Chinese Traditional and Western Medicine Hospital，Zhejiang Province，Taizhou 317500，China；2.Zhejiang Medical College，Hangzhou 310053，China
[Abstract] Objective To evaluate the sensitivity and specificity of rTpN15-17-47-ELISA，RPR and TPPA methods in serological diagnosis of syphilis. Methods The serum samples from 50 healthy individuals，11 RA patients，5 NS patients and 122 syphilis patients were detected by using rTpN15-17-47-ELISA，RPR and TPPA. The detection effect of the ELISA was compared to those of RPR and TPPA. Results The detection results of rTpN15-17-47-ELISA was negative for the serum samples from healthy individuals，RA and NS patients，while presented 97.5% positive detection rates for the serum samples from syphilis patients. The positive detection rates of rTpN15-17-47-ELISA was similar to that of TPPA(96.7%)(P>0.05)，both the positive rates of rTpN15-17-47-ELISA and TPPA were significantly higher than that of RPR(80.3%). Conclusion rTpN15-17-47-ELISA established in this study is great hopeful to become sensitivity and specificity methods for serological screening and detection of syphilis.
[Key words] Treponema pallidum；rTpN15-17-47-ELISA；Serological diagnosis
梅毒是由梅毒螺旋体(Treponema pallidum)感染引起的主要人类性传播性疾病(STD)之一[1]，因临床表现多样容易造成误诊、漏诊。目前梅毒的实验室诊断主要依赖血清学方法，快速血浆反应环卡片试验(RPR)是目前国内最常用的梅毒临床筛选试验，方法简便、快速，用于梅毒初筛，但特异性不强。明胶凝集试验(TPPA)为代表的特异性的梅毒确诊试验，方法敏感、特异，但需以培养的梅毒螺旋体为特异性抗原，梅毒螺旋体培养困难、成本高，使TPPA难以普及成为梅毒筛选试验[2，3]。本研究利用孙爱华教授建立的以重组蛋白rTpN15-17-47为包被抗原的ELISA并检测122份梅毒血清标本，并对方法的敏感性和特异性进行临床评价。
1 材料与方法
1.1 血清标本来源
梅毒患者血清122份(临床已确诊)由浙江省台州地区多家医院提供，收集上述血清标本医院已进行RPR和TPPA检测 ......
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