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目的比较四种梅毒血清学检测方法在梅毒确诊时的临床意义。方法收集因婚前检查或孕前检查时梅毒血清学筛查阳性并进一步至该院就诊确诊的患者血标本共32份,同时应用梅毒螺旋体明胶颗粒凝集试验(TPPA)、梅毒甲苯胺红不加热血清反应素试验(TRUST)对患者血清标本进行检测。乙肝五项、AIDS均进行检测,综合分析最终确诊是否患梅毒。结果 (1)TPPA筛查实验阳性者共9例,该院检测TPPA、TRUST后5例诊断为隐性梅毒,4例诊断为既往感染梅毒。(2)梅毒酶联免疫吸附测定法(TPELISA)阳性者共7例,该院检测后1例诊断为隐性梅毒,6例诊断为既往感染梅毒,已自愈。(3)快速血浆反应素试验(RPR)阳性者共9例,该院检测后诊断7例为梅毒,2例为假阳性。(4)TRUST筛查实验阳性者共7例,该院确诊3例为隐性梅毒,4例假阳性。结论四种梅毒血清学检测方法单独使用均不能确诊梅毒,需联合检测以提高临床诊断符合率。
Objective To compare the clinical significance of four syphilis serological tests in the diagnosis of syphilis. Methods A total of 32 blood samples were collected from patients who were positive for syphilis serology screening before pregnancy or preconception and then diagnosed with TPPA. Toxoplasma gondii did not react with serum Serum samples were tested by TRUST. Five hepatitis B, AIDS were detected, a comprehensive analysis of whether the final diagnosis of syphilis. Results (1) TPPA screening test was positive in a total of 9 cases, the hospital detection of TPPA, TRUST 5 cases were diagnosed as latent syphilis, 4 cases were diagnosed as previously infected with syphilis. (2) A total of 7 cases of positive TPELISA were diagnosed as latent syphilis in the hospital and 6 cases were diagnosed as previously infected with syphilis and self-healed. (3) There were 9 cases of positive RPR positive, 7 cases of syphilis were diagnosed in this hospital and 2 cases were false positive. (4) TRUST screening test was positive in 7 cases, the hospital confirmed 3 cases of latent syphilis, 4 cases of false positive. Conclusion The results of four syphilis serological tests can not be confirmed syphilis alone, and combined detection should be used to improve the coincidence rate of clinical diagnosis.