目的 比较快速血浆反应素试验(rapid plasma reagin, RPR)、胶体金试验(colloidal gold test for syphilis, SYP)、酶联免疫吸附试验(enzyme-linked immuno sorbent assay, ELISA)、凝集法(treponema pallidum particle assay, TPPA)诊断儿童梅毒的灵敏度及特异性。方法 选择本院120例确诊为梅毒的患儿及60例非梅毒患儿进行RPR、SYP、ELISA、TPPA实验, 统计4种方法 检测梅毒的阳性率、灵敏度、特异性及阳性预测值。结果 ELISA阳性率为94.2%、阳性预测值为95.8%、特异性为95.0%, RPR阳性率为43.3%, SYP灵敏度为66.7%。TPPA灵敏度、特异性及阳性预测率均不高。结论 ELISA的阳性预测值及特异性较高, 适合住院、门诊儿童的梅毒筛查, SYP可作为阳性标本的确认试验, 必要时可采用联合试验进行检测。建议对儿童梅毒检测, 不采用TPPA。

Objective To study the sensitivity and specificity of rapid plasma reagin test (RPR), colloidal gold test for syphilis(SYP), and enzyme-linked immune sorbent assay (ELISA), treponema pallidum particle assay (TPPA) test in diagnosis of syphilis in children. Methods 120 children with suspected syphilis were recruited in this hospital, and were divided into newborn group (60 cases) and infant group (60 cases) by age and other 60 children without syphilis were recruited.The RPR, SYP, ELISA, TPPA were conducted. By the statistical methods, syphilis positive rate, sensitivity, specificity, positive predictive value were counted. Results The positive rate of enzyme-linked immune method was 94.2%.The positive predictive value of enzyme-linked immune sovbent assay was 95.8% and specificity was 95.0%.The positive rate of rapid plasma reagin test was 43.3%. The sensitivity of colloidal gold method was 66.7%. The sensitivity, specificity, and positive predictive rate of TPPA were not high.Conclusions The positive predictive value and specificity of ELISA is high, and it is suitable for the diagnosis of syphilis in children.Colloidal gold method can be used for other screening positive specimens after confirmation and its joint testing can be used for testing if necessary. TPPA is not recommended for use in children for syphilis test.