7800例新生儿TPPA和TRUST检测

中华皮肤科杂志 ›› 2011, Vol. 44 ›› Issue (1): 50-52.

7800例新生儿TPPA和TRUST检测

叶青¹,陈学军²,李建平²,曹禾谦³

1. 浙江大学医学院附属儿童医院
2. 杭州浙江大学医学院附属儿童医院皮肤科
3. 杭州浙江大学医学院附属儿童医院

收稿日期:2010-04-13 修回日期:2010-08-12 出版日期:2011-01-15 发布日期:2011-01-10
通讯作者: 叶青 E-mail:yeqingkaoyan@yahoo.com.cn

Screening for congenital syphilis with TPPA and TRUST in 7800 neonates

Received:2010-04-13 Revised:2010-08-12 Online:2011-01-15 Published:2011-01-10

摘要/Abstract

摘要：

目的探讨非梅毒螺旋体抗原血清学试验和梅毒螺旋体抗原血清学试验检测胎传梅毒的价值及其临床实用性。方法对门诊及住院7800例新生儿用甲苯胺红不加热血清试验（TRUST）做非特异性抗体定量检测，梅毒螺旋体明胶颗粒凝聚集试验（TPPA）做特异性抗体定性检测。统计分析确诊的胎传梅毒患儿初次梅毒血清学试验结果。比较TPPA和TRUST试验的敏感度和特异性。结果进行血清学筛查的7800例新生儿中，初次梅毒血清学检测TPPA（+）、TRUST（+）60例，其中胎传梅毒患儿15例；初次梅毒血清学检测TPPA（+）、TRUST（-）47例，其中胎传梅毒患儿5例。TRUST试验检测胎传梅毒的敏感率为75%（5/20），特异性为99.41%（7734/7780）。TPPA试验检测胎传梅毒的敏感率为100%（20/20），特异性为98.88%（7693/7780）。结论 TPPA比TRUST更适用于胎传梅毒的筛查。

关键词: 血清学试验

Abstract:

Objective To assess the value and clinical applicability of non-treponemal antigen serologic test and Treponema pallidum antigen serologic test in the diagnosis of congenital syphilis. Methods Totally, 7800 newborns were collected from the out-patient and in-patient department. Toluidine red unheated serum test （TRUST） was conducted to quantitatively detect non-treponemal antibodies and Treponema pallidum particle agglutination assay （TPPA） to qualitatively detect specific treponemal antibodies in these subjects. The results of first serology test for syphilis were assessed for neonates with confirmed congenital syphilis. The sensitivity and specificity in the diagnosis of congenital syphilis were compared between TPPA and TRUST. Results Of the 7800 newborns undergoing syphilis serology tests, 60 were positive for TPPA and TRUST, including 15 cases of congenital syphilis, 47 were positive for TPPA but negative for TRUST, including 5 cases of congenital syphilis. The sensitivity and specificity were 75% （5/20） and 99.41% （7734/7780） respectively for TRUST in the diagnosis of congenital syphilis, 100% （20/20） and 98.88% （7693/7780） respectively for TPPA. Conclusion TPPA seems more applicable than TRUST to the screening for congenital syphilis.

Key words: Serological

叶青陈学军李建平曹禾谦. 7800例新生儿TPPA和TRUST检测[J]. 中华皮肤科杂志, 2011, 44(1): 50-52.

参考文献

参考文献 1 戴玉琳，冯星．对梅毒血清学研究的建议[J]．中国皮肤性病学杂志，2004，18(8)：505． 2 马兰,崔永鹏,张琦,等.婴幼儿获得性梅毒12例分析[J].浙江实用医学,2009,14（3）:228-234. 3 Larsen SA,Steiner BM,Rudolph AH.Laboratory diagnosis and interpretation of tests for syphilis[J]. Clin Microbiol Rev ,1995,8（1）:1-21. 4 Nandwani R,Evans DTP.Are you sure it’s syphilis?A review of false positive serology[J]. Int J STD AIDS, 1995,6（4）:241-248. 5 尹跃平.梅毒血清检测的应用评价[J].实用医院临床杂志,2006,3(2):12—13． 6 P French(Chair) FRCP,M Gomberg MD,M Janier MD PhD,et al. IUSTI:2008 European Guidelines on the Management of Syphilis[J]. International Journal of TD&AIDS ,2009,20:300-309. 7 World Health Organization.Sexually Transmitted Infections Management Guidelines. 2004;http://www.who.int/reproductive-health/stis/guidelines/mngt_stisguidelines_mgnt-stis.pdf(last accessed 2 March 2009). 8 Young H,Van Voorst Vader PC. Standard Serologic Testing for Syphilis in Individual Patients: The European View.2004.IUSTI/WHOConferenceonSTI. Europe Syphilis Guideline Expert Workshop,Mykonos,Greece. 9 Manavi K,Young H,McMillan A.The sensitivity of syphilis assays in detecting different stages of early syphilis[J]. Int J STD AIDS, 2006,11（17）:768-771. 10 Geusau A,Kittler H,Hein U,Dangl-Erlach E,Stingl G,Tschachler E. Biological false-positive tests comprise a high proportion of venereal disease research laboratory reactions in an analysis of 300,000sera[J]. Int J STD AIDS, 2005,16（11）:722-726. 11 Creegan L,Bauer HM,Samuel MC,Klausner J,Liska S,Bolan G.An evaluation of the relative sensitivities of the venereal disease research laboratory test and the Treponema pallidum particle agglutination test among patients with primary syphilis[J]. Sex Transm Dis ,2007,34（12）:1016-1018.

[1]	吴兴中,郑和平,黄进梅. 2004-2006年广东省性病实验室梅毒血清学检测能力分析[J]. 中华皮肤科杂志, 2008, 41(5): 314-.
[2]	沈建平, 李文忠, 魏万惠, 严良斌, 叶干运, 黄文标, 刘凤梧, 冉顺鹏, 刘聪华, 陆世学, 李廷光, 徐光恒, 张加荣. 麻风菌素试验和血清抗体检测联合监测麻风高危人群[J]. 中华皮肤科杂志, 1997, 30(6): 392-394.