摘要
通过检测梅毒患者正规治疗前、后血清抗体变化,评价梅毒实验室各种血清学试验方法对梅毒的诊断和随访的临床意义。本文采用梅毒螺旋体(TP)暗视野显微镜检查、快速血浆反应素(RPR)试验、TP明胶凝集试验(TPPA)和TP-IgM酶联免疫吸附试验(TP-IgMELISA)等方法对135例梅毒患者正规治疗前、后的血清进行检测。结果显示,治疗前,一期(硬下疳)梅毒血清试验的敏感度分别为83.3%、91.7%和91.7%,暗视野检查全部阳性;二期梅毒血清试验的敏感度均为100.0%;早期潜伏梅毒血清试验的敏感度分别为88.9%、100.0%和88.9%,说明3种梅毒血清学试验对未治疗梅毒患者的诊断中,TPPA试验的灵敏度最高。正规治疗12个月后,PRP和TP-IgMELISA对一期(硬下疳)梅毒患者检出结果均为阴性;对二期梅毒血清试验阴性率分别为64.5%和67.7%;对早期潜伏梅毒血清试验阴性率均为43.7%。即对正规治疗后的梅毒患者随访,TP-IgMELISA阴性,RPR试验也基本阴性。由于TP-IgMELISA试剂昂贵,可以用RPR试验代替。综上所述,TPPA和RPR试验适合用于梅毒的常规诊断和随访。
The purpose of the current study is to evaluate the value of various serological techniques for laboratory diagnosis in syphilis patients before and after the standard treatment.Dark field microscopy,rapid plasma reagin（RPR）,Treponema pallidum particle assay（TPPA）and TP-IgM enzyme-linked immunosorbent assay（ELISA）were used to monitor 135 syphilis patients before and after treatment.In 24 cases of primary chancre syphilis,the dark field microscopy was 100% positive,and the positive rates for RPR,TPPA and TP-IgM ELISA were 83.3%,91.7% and 91.7%,respectively.All the serological tests were positive in 93 patients with secondary syphilis.In 18 early latent syphilis cases,the positive rates for RPR,TPPA and TP-IgM ELISA were 88.9%,100.0% and 88.9%,respectively.At 12 months after completion of the treatment,RPR and TP-IgM ELISA tests were negative in 100.0% of primary syphilis patients,and 64.5% and 67.7% negative,respectively,in 93 secondary syphilis patients.Among 18 early latent syphilis patients,RPR and TP-IgM ELISA tests were both negative in 43.7% of the patiens.These results showed that when RPR and TP-IgM ELISA tests are positive,TPPA test is also positive in previously untreated syphilis patients.TPPA has higher sensitivity to detect early latent syphilis.To follow patients after completion of treatment,RPR test is basically negative whenever TP-IgM ELISA test is negative.Because TP-IgM ELISA test is expensive,the above results indicate that RPR and TPPA tests are effective serological tests for syphilis in routine clinical diagnosis and follow-up after treatment.
出处
《微生物与感染》
2011年第1期23-26,共4页
Journal of Microbes and Infections
作者简介
通信作者：龚匡隆Corresponding author. GONG Kuang-Long, E-mail： ztp512@yahoo, com. cn
