TRUST和TPPA,怎么看梅毒检验结果?

2017-10-08 高继娟 检验视界网

梅毒是由梅毒螺旋体引起的一种危害人类健康的性传播疾病,临床表现复杂,呈多样性,容易出现漏诊和误诊。目前,梅毒血清学检查是诊断梅毒的重要依据,对梅毒早期诊断,发现传染源及控制梅毒传播具有重要意义。因此,全面的认识和了解梅毒抗体检测对指导临床诊断和疗效观察具有重要意义。


作者:上海市东方医院南院检验科  高继娟

梅毒是由梅毒螺旋体引起的一种危害人类健康的性传播疾病,临床表现复杂,呈多样性,容易出现漏诊和误诊。目前,梅毒血清学检查是诊断梅毒的重要依据,对梅毒早期诊断,发现传染源及控制梅毒传播具有重要意义。因此,全面的认识和了解梅毒抗体检测对指导临床诊断和疗效观察具有重要意义。

梅毒螺旋体侵入人体后可刺激机体产生两类抗体:一类为抗密螺旋体的特异性抗体,而另一类抗体是一种非特异性抗体。为了提高梅毒的诊断率,通常结合甲苯胺红不加热血清试验(TRUST)及梅毒螺旋体明胶凝集试验(TPPA)两种方法进行检测。

TRUST即通常所说的梅毒非特异性抗体检测,该抗体是针对梅毒螺旋体损害机体组织后释放出的物质而产生的自身抗体,称为反应素,该抗体的出现要较特异性抗体晚(约迟2周),主要测定血清中的心磷脂抗体。梅毒感染发病时该抗体可呈阳性,治愈后转阴,可指示病情的严重程度、治疗效果、疾病转归,是梅毒螺旋体感染筛查试验。TRUST越高,说明病情可能相对比较严重,或者是处于早期。

TPPA即通常所说的梅毒特异性抗体检测,在梅毒的潜伏期即可产生(约感染后2周),常用作梅毒螺旋体感染的确证试验,部分患者治愈后仍可终生阳性。滴度的高低对于判断梅毒的病情无较大意义,而是梅毒感染的证据。

这两个检测需要结合来看:

第一种情况:TRUST试验阳性,TPPA试验阳性,为正在感染梅毒。 

第二种情况:TRUST试验阴性,TPPA试验阳性。分析如下:①多数为既往感染梅毒,现已治愈或自愈,当前无传染性无需治疗,观察半年后进行复查;②感染梅毒的非常早期,TRUST还测不到,TPPA产生时间较早,该种情况需复查;③机体本身存在免疫缺陷,感染梅毒后抗体产生有问题,故需排除艾滋病毒感染及其他对抗体生成有影响的疾病;④假阳性结果,可通过荧光密螺旋体抗体吸附实验(FTA-ABS)进行确认。

第三种情况:TRUST试验阳性,TPPA试验阴性。表明从未感染过梅毒,TRUST可能为假阳性,建议一个月后再复查TPPA。

总之,TPPA是判断是否感染过梅毒的重要检测指标。TRUST试验一般用于梅毒的诊断筛选,阳性时应做TPPA试验加以确诊。而对于感染后的病情程度,治疗的效果的观察则以TRUST结果为重要参考。两者联合检测对于做好早发现,早诊断,早治疗,切断传染途径,有效地控制梅毒流行蔓延尤为重要。

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    2023-04-13 栗子大大的 来自浙江省

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    2018-01-02 wgsun
  4. [GetPortalCommentsPageByObjectIdResponse(id=2125762, encodeId=eccd2125e620d, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLYn58ricuKNFderEfxY0lxGCx3AicboOjdO99VRwHbkdaAmkP3W0IZibWycqxYbWZGdAUwqQFiaYMdgA/132, createdBy=5cae2215013, createdName=栗子大大的, createdTime=Thu Apr 13 22:19:38 CST 2023, time=2023-04-13, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1635890, encodeId=2db21635890e8, content=<a href='/topic/show?id=6c266244ef3' target=_blank style='color:#2F92EE;'>#梅毒检验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62447, encryptionId=6c266244ef3, topicName=梅毒检验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=750e22536519, createdName=斯嘉莉, createdTime=Sat May 26 09:02:00 CST 2018, time=2018-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643032, encodeId=43ba1643032f1, content=<a href='/topic/show?id=f2621e8740a' target=_blank style='color:#2F92EE;'>#TRUST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17874, encryptionId=f2621e8740a, topicName=TRUST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af2d23060544, createdName=wgsun, createdTime=Tue Jan 02 20:02:00 CST 2018, time=2018-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677000, encodeId=337316e7000be, content=<a href='/topic/show?id=820f62595c4' target=_blank style='color:#2F92EE;'>#检验结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62595, encryptionId=820f62595c4, topicName=检验结果)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da0427418680, createdName=yinxm8312, createdTime=Sun Jul 22 19:02:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252871, encodeId=94712528e1a3, content=现在梅毒越来越多.值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJUlbw1Mf1vppicGcaWPx1YUOgLgKccao77Rykbx3jiazqzwcyXMdzRIZkhFyBPqknibeuOGhXI1VzVg/0, createdBy=7f162154630, createdName=沙漠浪人, createdTime=Sat Oct 14 13:29:41 CST 2017, time=2017-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252082, encodeId=1ce22520826c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Thu Oct 12 05:05:23 CST 2017, time=2017-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480729, encodeId=75a11480e29a1, content=<a href='/topic/show?id=341f1e7069c' target=_blank style='color:#2F92EE;'>#TPPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17706, encryptionId=341f1e7069c, topicName=TPPA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=95757671694, createdName=more is better!, createdTime=Tue Oct 10 06:02:00 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251521, encodeId=4bb2251521b5, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Oct 09 12:41:04 CST 2017, time=2017-10-09, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2125762, encodeId=eccd2125e620d, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLYn58ricuKNFderEfxY0lxGCx3AicboOjdO99VRwHbkdaAmkP3W0IZibWycqxYbWZGdAUwqQFiaYMdgA/132, createdBy=5cae2215013, createdName=栗子大大的, createdTime=Thu Apr 13 22:19:38 CST 2023, time=2023-04-13, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1635890, encodeId=2db21635890e8, content=<a href='/topic/show?id=6c266244ef3' target=_blank style='color:#2F92EE;'>#梅毒检验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62447, encryptionId=6c266244ef3, topicName=梅毒检验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=750e22536519, createdName=斯嘉莉, createdTime=Sat May 26 09:02:00 CST 2018, time=2018-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643032, encodeId=43ba1643032f1, content=<a href='/topic/show?id=f2621e8740a' target=_blank style='color:#2F92EE;'>#TRUST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17874, encryptionId=f2621e8740a, topicName=TRUST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af2d23060544, createdName=wgsun, createdTime=Tue Jan 02 20:02:00 CST 2018, time=2018-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677000, encodeId=337316e7000be, content=<a href='/topic/show?id=820f62595c4' target=_blank style='color:#2F92EE;'>#检验结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62595, encryptionId=820f62595c4, topicName=检验结果)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da0427418680, createdName=yinxm8312, createdTime=Sun Jul 22 19:02:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252871, encodeId=94712528e1a3, content=现在梅毒越来越多.值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJUlbw1Mf1vppicGcaWPx1YUOgLgKccao77Rykbx3jiazqzwcyXMdzRIZkhFyBPqknibeuOGhXI1VzVg/0, createdBy=7f162154630, createdName=沙漠浪人, createdTime=Sat Oct 14 13:29:41 CST 2017, time=2017-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252082, encodeId=1ce22520826c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Thu Oct 12 05:05:23 CST 2017, time=2017-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480729, encodeId=75a11480e29a1, content=<a href='/topic/show?id=341f1e7069c' target=_blank style='color:#2F92EE;'>#TPPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17706, encryptionId=341f1e7069c, topicName=TPPA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=95757671694, createdName=more is better!, createdTime=Tue Oct 10 06:02:00 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251521, encodeId=4bb2251521b5, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Oct 09 12:41:04 CST 2017, time=2017-10-09, status=1, ipAttribution=)]
    2017-10-14 沙漠浪人

    现在梅毒越来越多.值得推荐

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2125762, encodeId=eccd2125e620d, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLYn58ricuKNFderEfxY0lxGCx3AicboOjdO99VRwHbkdaAmkP3W0IZibWycqxYbWZGdAUwqQFiaYMdgA/132, createdBy=5cae2215013, createdName=栗子大大的, createdTime=Thu Apr 13 22:19:38 CST 2023, time=2023-04-13, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1635890, encodeId=2db21635890e8, content=<a href='/topic/show?id=6c266244ef3' target=_blank style='color:#2F92EE;'>#梅毒检验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62447, encryptionId=6c266244ef3, topicName=梅毒检验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=750e22536519, createdName=斯嘉莉, createdTime=Sat May 26 09:02:00 CST 2018, time=2018-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643032, encodeId=43ba1643032f1, content=<a href='/topic/show?id=f2621e8740a' target=_blank style='color:#2F92EE;'>#TRUST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17874, encryptionId=f2621e8740a, topicName=TRUST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af2d23060544, createdName=wgsun, createdTime=Tue Jan 02 20:02:00 CST 2018, time=2018-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1677000, encodeId=337316e7000be, content=<a href='/topic/show?id=820f62595c4' target=_blank style='color:#2F92EE;'>#检验结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62595, encryptionId=820f62595c4, topicName=检验结果)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da0427418680, createdName=yinxm8312, createdTime=Sun Jul 22 19:02:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252871, encodeId=94712528e1a3, content=现在梅毒越来越多.值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJUlbw1Mf1vppicGcaWPx1YUOgLgKccao77Rykbx3jiazqzwcyXMdzRIZkhFyBPqknibeuOGhXI1VzVg/0, createdBy=7f162154630, createdName=沙漠浪人, createdTime=Sat Oct 14 13:29:41 CST 2017, time=2017-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252082, encodeId=1ce22520826c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Thu Oct 12 05:05:23 CST 2017, time=2017-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480729, encodeId=75a11480e29a1, content=<a href='/topic/show?id=341f1e7069c' target=_blank style='color:#2F92EE;'>#TPPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17706, encryptionId=341f1e7069c, topicName=TPPA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=95757671694, createdName=more is better!, createdTime=Tue Oct 10 06:02:00 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251521, encodeId=4bb2251521b5, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Oct 09 12:41:04 CST 2017, time=2017-10-09, status=1, ipAttribution=)]
    2017-10-12 半夏微凉

    学习了谢谢分享

    0

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    2017-10-09 天涯183

    非常好的文章.学习了

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