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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。
Objective: To evaluate the role of quantitative detection of syphilis spirochete particle agglutination test (TPPA) in the diagnosis of fetal syphilis. Methods: 155 pregnant women diagnosed with syphilis and their newborn infants were tested by TPPA and RPR. The 18-month follow-up of TPPA test was positive as the final diagnosis standard of fetal syphilis . Results: Of the 155 newborns, 27 cases of syphilis were confirmed by 18 months follow-up. Among 155 newborns and their mother, the titer of TPPA ≥ 14 in 14 cases, including 13 cases of fetal syphilis with a sensitivity of 48.15% (95% CI: 29.30% -67.00%). The ratio of newborns to their mothers 7 cases were more than 4, of which 6 cases were fetal syphilis with a sensitivity of 22.22% (95% CI: 6.54% -37.90%). The difference was statistically significant (P = 0.046). The specificity of the two methods were 99.22%. Conclusion: Compared with RPR quantitative test, TPPA quantitative test can significantly improve the diagnosis rate of syphilis.