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学科主题: 临床检验诊断学
题名:
梅毒螺旋体抗体筛查方法的比较性研究
其他题名: Comparative study of five analytical methods for screening of antibodies against treponema pallidum
作者: 李志艳; 刘平; 高健; 东锦华; 闫存玲; 冯珍如
关键词: 梅毒螺旋体抗体 ; 梅毒 ; 血清学试验 ; 筛查 ; Antibodies against treponema pallidum ; Syphilis ; Serological test ; Screening
刊名: 中华检验医学杂志
发表日期: 2012
DOI: 10.3760/cma.j.issn.1009-9158.2012.12.027
卷: 35, 期:12, 页:1176-1179
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 分析评价5种梅毒螺旋体抗体筛查梅毒方法的临床价值.方法 用化学发光微粒子免疫法(CMIA)、ELISA、梅毒螺旋体明胶凝集试验(TPPA)、快速血浆反应素环状卡片试验(RPR)和斑点免疫印迹(dot-IBT)检测2010年5至10月期间,北京大学第一医院各门诊及病房进行梅毒螺旋体感染筛查者4870份标本,各种方法检测间阳性率比较,采用配对资料McNemar检验;以dot-IBT为标准,评价其他4种方法检测的敏感度、特异度和总符合率.结果 4870份标本中,dot-IBT筛查阳性率为2.5% (122/4870),CMIA、RPR阳性率分别为3.1% (149/4870)和1.2%(58/4870),根据配对资料McNemar检验分析,与dot-IBT比较差异均有统计学意义(P均<0.01).ELISA、TPPA阳性率分别为2.4% (119/4870)和2.4% (116/4870),与dot-IBT比较差异均无统计学意义(P均>0.05).以dot-IBT结果为标准,CMIA的敏感度为96.7% (118/122),特异度为99.6% (4705/4724),ELISA敏感度为93.4%(114/122),特异度为99.9% (4720/4724),TPPA敏感度为91.0% (111/122),特异度为99.9% (4721/4724),RPR敏感度为46.7% (57/122),特异度为100.0% (4724/4724).CMIA、ELISA和TPP、RPR法与dot-IBT检测总符合率分别为99.5% (4823/4846),99.8%(4834/4846)、99.7% (4832/4846)和98.7% (4781/4846).以TPPA结果为标准,CMIA的敏感度96.6% (112/116),特异度为99.2% (4717/4754),ELISA的敏感度、特异度分别为98.3% (114/116)和99.9% (4749/4754),RPR的敏感度为47.4% (55/116),特异度为99.9% (4751/4754).CMIA、ELISA和RPR与TPPA检测总符合率分别为99.2%(4829/4870)、99.9% (4863/4870)和98.7% (4806/4870).结论 RPR敏感度较低,不适用于梅毒螺旋体感染的筛查.CMIA、ELISA检测梅毒螺旋体抗体的敏感度和特异度较高,适用于临床大样本量筛查.TPPA由于操作步骤复杂,适用于进一步确认试验. Objectives To evaluate the value of Treponema pallidum (TP) antibody analytical methods for syphilis screening.Methods A total of 4870 samples of Peking University First Hospital from May to October 2010 were detected of antibodies against TP by chemiluminescent microparticle immunoassay (CMIA),ELISA,rapid plasma reagin test (RPR),Treponema pallidum particle agglutination assay (TPPA) and dot-immunoblotting test (dot-IBT).The positive rates were compared by McNemar test for paired data;Using dot-IBT as gold standard,the sensitivity,specificity and total accordance rate of the other four methods were analyzed.Results In 4870 screening samples,the positive rate of dot-IBT was 2.5%(122/4870).The positive rate of CMIA and RPR was 3.1%(149/4870) and 1.2%(58/4870),respectively.According to McNemar test for paired data,there was significant difference when compared with dot-IBT (P <0.01).The positive rate of ELISA and TPPA was 2.4% (119/4870) and 2.4% (116/4870),respectively.There was no significant difference when compared with dot-IBT (P > 0.05).When the dot-IBT results for the standard,CMIA has highest sensitivity,96.7% (118/122),the specificity was 99.6%(4705/4724).The sensitivity and specificity of ELISA was 93.4% (114/122) and 99.9% (4720/4724),respectively,TPPA was 91.0% (111/122) and 99.9% (4721/4724),respectively,and RPR was 46.7%(57/122) and 100.0% (4724/4724),respectively.The accordance rate of CMIA,ELISA,TPPA and RPR with the dot-IBT was 99.5% (4823/4846),99.8% (4834/4846),99.7% (4832/4846) and 98.7%(4781/4846).When the TPPA results for the standard,sensitivity of CMIA was 96.6% (112/116),the specificity was 99.2% (4717/4754).The sensitivity and specificity of ELISA was 98.3 % (114/116) and 99.9% (4749/4754),respectively,and RPR was 47.4% (55/116) and 99.9% (4751/4754),respectively.The accordance rate of CMIA,ELISA and RPR with the dot-IBT was 99.2% (4829/4870),99.9% (4863/4870) and 98.7% (4806/4870).Conclusions Because of the low sensitivity of RPR,it is not fit for screening test.There are high sensitivity and specificity for detection of TP antibody using CMIA and ELISA,so they could be used as a screening test for TP.Due to the complexity of the operating steps,TPPA can be used to further confirm the test.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/43612
Appears in Collections:北京大学第一临床医学院_检验科_期刊论文

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作者单位: 100034,北京大学第一医院检验科

Recommended Citation:
李志艳,刘平,高健,等. 梅毒螺旋体抗体筛查方法的比较性研究[J]. 中华检验医学杂志,2012,35(12):1176-1179.
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