孕期梅毒筛查：哪种方法才是恰当的？

Screening for syphilis in pregnancy: which is the proper method?

作者信息

Wiwanitkit Viroj

机构信息

Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.

出版信息

Arch Gynecol Obstet. 2007 Dec;276(6):629-31. doi: 10.1007/s00404-007-0400-y. Epub 2007 Jun 14.

DOI:10.1007/s00404-007-0400-y

PMID:17569069

Abstract

BACKGROUND

Consequences of syphilis in mother, pregnancy, fetus and child are considerable, but preventable. Serological screening must be offered at the first prenatal visit. Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR) and for confirmation the fluorescent treponemal antibody (FTA) and the treponema pallidum hemagglutination (TPHA) tests.

METHOD

The four alternative nodes for diagnosis of can be a) VDRL + FTA, b) VDRL + TPHA, c) RPR + FTA and d) RPR + TPHA. Here the author reports an evaluation of cost utility of those tests in obstetrical practice. According to this study, it can be shown that the cost per accurate diagnosis for VDRL + TPHA is the least expensive choice and for RPR + FTA is the most expensive choice.

CONCLUSION

Therefore, this alternative is the best method for serological diagnosis of syphilis, based on medical laboratory economics principles.

摘要

背景

梅毒对母亲、妊娠、胎儿和儿童的影响相当大，但可以预防。首次产前检查时必须进行血清学筛查。目前，梅毒的诊断主要依赖血清学检测。梅毒最常用的筛查试验是性病研究实验室试验（VDRL）和快速血浆反应素试验（RPR），用于确诊的是荧光密螺旋体抗体试验（FTA）和梅毒螺旋体血凝试验（TPHA）。

方法

诊断的四种替代组合可以是：a）VDRL + FTA，b）VDRL + TPHA，c）RPR + FTA，d）RPR + TPHA。在此，作者报告了这些试验在产科实践中的成本效用评估。根据这项研究，可以表明，VDRL + TPHA每准确诊断一例的成本是最便宜的选择，而RPR + FTA是最昂贵的选择。