抗梅毒螺旋体IgG酶免疫测定：筛查试验还是确诊试验？
Enzyme immunoassay for anti-treponemal IgG: screening or confirmatory test?
作者信息
Young H, Moyes A, McMillan A, Patterson J
机构信息
Department of Medical Microbiology, University Medical School, Edinburgh.
出版信息
J Clin Pathol. 1992 Jan;45(1):37-41. doi: 10.1136/jcp.45.1.37.
AIMS
To review the performance of the Venereal Diseases Research Laboratory (VDRL) test and the Treponema pallidum haemagglutination assay (TPHA) as a combined screen for syphilis to provide a baseline for assessing screening by anti-treponemal IGG EIA.
METHODS
Between 1980 and 1987 all serum samples were screened by both VDRL and TPHA tests. The FTA-ABS test was also used in suspected early primary syphilis, or when one of the other tests was positive. A positive result in a screening test was confirmed by quantitative testing. From 1988 all specimens were screened with an enzyme immunoassay (Captia Syph G) as a single screening test.
RESULTS
Of the 44 primary, 47 secondary, and 38 early latent cases of syphilis, the VDRL and TPHA detected 32 (73%) and 31 (71%) of the primary cases; the combination detected 37 (84%). All 85 cases of cases of secondary and early latent infection were reactive in the TPHA test, whereas the VDRL was reactive in only 68 (80%). EIA had a reported sensitivity of 82% for primary infection.
CONCLUSIONS
EIA can be used as a single screening test for detecting early syphilis because its results are comparable with those of the combined VDRL and TPHA tests. The conventional VDRL test should not be used as a single screening test.
目的
回顾性病研究实验室（VDRL）试验和梅毒螺旋体血凝试验（TPHA）联合用于梅毒筛查的表现，为评估抗梅毒螺旋体IgG酶免疫测定（EIA）筛查提供基线。
方法
1980年至1987年期间，所有血清样本均通过VDRL和TPHA试验进行筛查。荧光螺旋体抗体吸收试验（FTA - ABS）也用于疑似早期一期梅毒，或其他试验之一呈阳性时。筛查试验的阳性结果通过定量检测进行确认。1988年起，所有标本均采用酶免疫测定（Captia Syph G）作为单一筛查试验。
结果
在44例一期、47例二期和38例早期潜伏梅毒病例中，VDRL和TPHA分别检测出32例（73%）和31例（71%）一期病例；联合检测出37例（84%）。所有85例二期和早期潜伏感染病例在TPHA试验中均呈反应性，而VDRL仅在68例（80%）中呈反应性。EIA对一期感染的报告敏感性为82%。
结论
EIA可作为检测早期梅毒的单一筛查试验，因为其结果与VDRL和TPHA联合试验的结果相当。传统的VDRL试验不应作为单一筛查试验使用。
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