TPPA定量试验在胎传梅毒诊断中的应用

摘要

Objective:To assess the effect of the quantitative test for treponemal pallidum particle aggluti-nation ( TPPA) in the diagnosis of congenital syphilis. Methods: TPPA and rapid plasma regain ( RPR) in 155 pregnant women with syphilis and their neonates were performed. The positive of TPPA was taken as the diagnosis standard for congenital syphilis at 18 months after birth. Results:Twenty seven cases with congenital syphilis were ultimately diagnosed. The TPPA titer ratio of neonate-mother was greater than 4 in 14 cases, of which 13 were patients with congenital syphilis. The sensitivity of TPPA titer ratio of neonate-mother for the diagnosis of congenital syphilis was 48.15% (95% CI:29.30%-67.00%). The RPR titer ratio of neonate-mother was greater than 4 in 7 cases, of which 6 were the patients with congenital syphilis. The sensitivity of RPR titer ratio of neonate-mother for the diagnosis of congenital syphilis was 22. 22% ( 95% CI:6. 54%-37.90%) . There was a significant difference in the sensitivity between TPPA and RPR titer testings for the di-agnosis of congenital syphilis ( P = 0. 046 ) . The specificity of the two methods was 99. 22% in each. Conclusion:The accuracy of quantitative test for TPPA is greater than RPR in the diagnosis of congenital syphilis.%目的:评价梅毒螺旋体颗粒凝集试验(TPPA)定量检测在胎传梅毒诊断中的作用.方法:对确诊梅毒的155例孕产妇及其所生新生儿进行TPPA和快速血浆反应素环状卡片试验(RPR)定量检测,以18个月婴儿随访TPPA试验结果阳性作为胎传梅毒最终诊断标准.结果:155例新生儿经18个月随访最终确诊胎传梅毒27例.155例新生儿与其生母TPPA滴度之比≥4者14例,其中13例为胎传梅毒,灵敏度为48.15%(95%CI:29.30%~67.00%);新生儿与其生母RPR滴度之比≥4者7例,其中6例为胎传梅毒,灵敏度为22.22%(95%CI:6.54%~37.90%);两者差异有统计学意义(P=0.046).两种方法的特异度均为99.22%.结论:TPPA定量试验较RPR定量试验可显著提高胎传梅毒的确诊率.