摘要
目的分析抗心磷脂抗体(ACA)在不同梅毒血清学诊断方法中的表现,探讨ACA的本质及其在梅毒快速诊断中的应用可能。方法分别采集50例梅毒患者及77例非梅毒患者的血清标本,与15例健康体检者血清标本进行对照,利用酶联免疫吸附法(ELISA)及免疫印迹法(WB)检测ACA,并进行快速血浆反应素环状卡片试验(RPR)。结果 ELISA检测β2-GPⅠ型ACA诊断梅毒的敏感性、特异性、阳性预期值及阴性预期值分别为38.00%,79.35%,50.00%和70.19%,RPR检测反应素诊断梅毒的敏感性、特异性、阳性预期值及阴性预期值分别为96.00%,98.92%,97.96%和97.85%。在50例梅毒患者血清中,RPR,ELISA和WB检测的阳性率分别为96.00%,38.00%和56.00%;梅毒患者血清RPR的阳性率明显高于ELISA和WB检测ACA的阳性率(P<0.05)。本研究对92例非梅毒患者进行RPR检测,发现仅有1例梅毒生物学假阳性,假阳性率为1.1%。结论反应素的本质是一群针对磷脂成分的抗体,ACA是其主要成分。梅毒患者血清中存在β2-GPⅠ型ACA,其可能是导致RPR生物学假阳性的原因之一。
Objective To evaluate antieardiolipin antibody（ACA） detection in diagnosis of syphilis. Methods Com-pared serum specimen obtained from patients of syphilis with those from patients of autoimmune diseases, thrombotic tendency, hepatitis C, and healthy people. ELISA and Western blot were used to detect ACA. The results were compared with RPR. Results The sensitivity, specificity, positive predictive value（PPV） and the negative predictive value（NPV） of ELISA diagnosing syphilis in detection of beta 2-dependent cardi- olipin antibodies（ β2-GP I ACA） were 38% , 79.35% , 50% and 70.19%. It were 96% , 98.92% , 97. 96% and 97.85% in detection of the regain with RPR. The sensitivity of diagnosing syphilis were 96% , 38% and 56% , respectively with RPR, ELISA and western blot （ P 〈 0.05 ）. There was one positive sample in the non-syphilis group which was confirmed as biological false positive. The BFP rate was 1.1% in this study. Conclusion The reagin detected within syphilis patients is a group of antibodies against phospholip-id, including anticardiolipin. The sensitivity of ELISA and WB detecting ACA is lower than RPR when diag- nosing syphilis. β2-GP I ACA maybe is one of the reasons for the biological false positive for RPR.
出处
《中国皮肤性病学杂志》
CAS
北大核心
2013年第5期482-484,共3页
The Chinese Journal of Dermatovenereology
基金
北京市自然科学基金资助项目(7102079)
