中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2011年
2期
127-129
,共3页
林路洋%杨日东%张锡宝%徐琳%宋卫忠%毕超%梁艳华%李仰琪%曹文苓%李季%王焕丽%钟道清
林路洋%楊日東%張錫寶%徐琳%宋衛忠%畢超%樑豔華%李仰琪%曹文苓%李季%王煥麗%鐘道清
림로양%양일동%장석보%서림%송위충%필초%량염화%리앙기%조문령%리계%왕환려%종도청
神经梅毒%梅毒血清诊断%敏感性与特异性%曲线下面积
神經梅毒%梅毒血清診斷%敏感性與特異性%麯線下麵積
신경매독%매독혈청진단%민감성여특이성%곡선하면적
Neurosyphilis%Syphilis serodiagnosis%Sensitivity and specificity%Area under curve
目的 探讨性病研究实验室试验(VDRL)与几种检测方法在神经梅毒诊断中的敏感性和特异性差异.方法 取未经治疗或经治疗梅毒血清固定的隐性梅毒患者脑脊液(CSF),进行VDRL、RPR、TPPA、荧光梅毒螺旋体抗体吸收试验(FTA-ABS)、CSF常规和生化等检查.比较VDRL与这几种试验的敏感性、特异性、阳性预测值、阴性预测值的差异.结果 在总共61例符合隐性梅毒诊断的病例中,CSFRPR的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)分别为93.44%(57/61)、99.32%(293/295)、96.61%(57/59)、98.65%(293/297),CSF-TPPA分别为91.80%(56/61)、82.71%(244/295)、52.34%(56/107)、97.99(244/249),CSF-FTA-ABS分别为93.44%(57/61)、82.71%(244/295)、52.78%(57/108)、98.39%(244/248),蛋白定量分别为49.18%(30/61)、97.29%(287/295)、78.95%(30/38)、90.25%(287/318).结论 目前CSF-RPR、CSF-TPPA、CSF-FTA-ABS、蛋白定量等均不能替代CSF-VDRL作为NS诊断试验.CSF-RPR有较高的敏感性和特异性,其诊断效用指标ROC(receiver operating characteristic)曲线下面积(area under curve,AUC)与CSF-TPPA、CSF-FTA-ABS以及蛋白定量有统计学差异.
目的 探討性病研究實驗室試驗(VDRL)與幾種檢測方法在神經梅毒診斷中的敏感性和特異性差異.方法 取未經治療或經治療梅毒血清固定的隱性梅毒患者腦脊液(CSF),進行VDRL、RPR、TPPA、熒光梅毒螺鏇體抗體吸收試驗(FTA-ABS)、CSF常規和生化等檢查.比較VDRL與這幾種試驗的敏感性、特異性、暘性預測值、陰性預測值的差異.結果 在總共61例符閤隱性梅毒診斷的病例中,CSFRPR的敏感性、特異性、暘性預測值(PPV)、陰性預測值(NPV)分彆為93.44%(57/61)、99.32%(293/295)、96.61%(57/59)、98.65%(293/297),CSF-TPPA分彆為91.80%(56/61)、82.71%(244/295)、52.34%(56/107)、97.99(244/249),CSF-FTA-ABS分彆為93.44%(57/61)、82.71%(244/295)、52.78%(57/108)、98.39%(244/248),蛋白定量分彆為49.18%(30/61)、97.29%(287/295)、78.95%(30/38)、90.25%(287/318).結論 目前CSF-RPR、CSF-TPPA、CSF-FTA-ABS、蛋白定量等均不能替代CSF-VDRL作為NS診斷試驗.CSF-RPR有較高的敏感性和特異性,其診斷效用指標ROC(receiver operating characteristic)麯線下麵積(area under curve,AUC)與CSF-TPPA、CSF-FTA-ABS以及蛋白定量有統計學差異.
목적 탐토성병연구실험실시험(VDRL)여궤충검측방법재신경매독진단중적민감성화특이성차이.방법 취미경치료혹경치료매독혈청고정적은성매독환자뇌척액(CSF),진행VDRL、RPR、TPPA、형광매독라선체항체흡수시험(FTA-ABS)、CSF상규화생화등검사.비교VDRL여저궤충시험적민감성、특이성、양성예측치、음성예측치적차이.결과 재총공61례부합은성매독진단적병례중,CSFRPR적민감성、특이성、양성예측치(PPV)、음성예측치(NPV)분별위93.44%(57/61)、99.32%(293/295)、96.61%(57/59)、98.65%(293/297),CSF-TPPA분별위91.80%(56/61)、82.71%(244/295)、52.34%(56/107)、97.99(244/249),CSF-FTA-ABS분별위93.44%(57/61)、82.71%(244/295)、52.78%(57/108)、98.39%(244/248),단백정량분별위49.18%(30/61)、97.29%(287/295)、78.95%(30/38)、90.25%(287/318).결론 목전CSF-RPR、CSF-TPPA、CSF-FTA-ABS、단백정량등균불능체대CSF-VDRL작위NS진단시험.CSF-RPR유교고적민감성화특이성,기진단효용지표ROC(receiver operating characteristic)곡선하면적(area under curve,AUC)여CSF-TPPA、CSF-FTA-ABS이급단백정량유통계학차이.
Objective To compare the sensitivity and specificity of venereal disease research laboratory (VDRL) test versus several other laboratory tests in the diagnosis of neurosyphilis. Methods Lumber puncture was conducted to obtain cerebrospinal fluid (CSF) from untreated outpatients with latent syphilis (LS) or serofast outpatients with LS. Then, VDRL test, rapid plasma regain (RPR) test, Treponema pallidum particle agglutination (TPPA) assay, fluorescent treponemal antibody-absorption (FTA-ABS) test and protein quantification were performed on these CSF samples. The sensitivity, specificity, positive predictive value and negative predictive value were compared between VDRL test and four other laboratory tests in the diagnosis of neurosyphilis. Results Totally, 61 cases of latent syphilis were included in this study. The sensitivity, specificity,positive predictive value and negative predictive value were 93.44% (57/61), 99.32%(293/295), 96.61%(57/59), 98.65% (293/297)for CSF-RPR, respectively, 91.80% (56/61), 82.71% (244/295), 52.34% (56/107),97.99 (244/249) for CSF-TPPA, respectively, 93.44% (57/61), 82.71% (244/295), 52.78%(57/108), 98.39%(244/248) for CSF-FTA-ABS, respectively, and 49.18%(30/61), 97.29% (287/295), 78.95% (30/38),90.25% (287/318) for CSF protein quantification, respectively. Conclusions CSF-VDRL cannot be replaced by CSF-RPR, -TPPA, -FTA-ABS, or CSF protein quantification in the diagnosis of neurosyphilis. CSF-RPR shows a high sensitivity and specificity in the diagnosis of neurosyphilis, with an increased diagnostic capability (area under the receiver operating characteristic curve) compared with CSF-TPPA, CSF-FTA-ABS or CSF protein quantification.
