梅毒螺旋体IgM抗体对于神经梅毒的诊断意义

Diagnostic Significance of IgM Antibodies to Treponema Pallidum in Cerebrospinal Fluid for Neurosyphilis

目的 探讨检测脑脊液中梅毒螺旋体IgM抗体对于神经梅毒的诊断意义。 方法 神经梅毒组 2 1例 ,以无神经系统被累的各期梅毒组 2 8例、非梅毒组 2 8例为对照。对三组患者腰穿取脑脊液 ,采用抗体捕获酶联免疫吸附分析技术 ,进行梅毒螺旋体IgM抗体检测。 结果 神经梅毒组脑脊液Tp IgM检测的阳性率为 71.4% ,两对照组则均为 0 ,差异有高度显著性 (u =5 .3 7,P <0 .0 1)。脑脊液Tp IgM试验、VDRL/RPR试验在神经梅毒组的阳性率分别为 71.4%、3 3 .3 % ,差异有显著性 (χ2 =4.90 ,P <0 .0 5 )。结论 脑脊液Tp IgM检测有助于神经梅毒的诊断 ,无症状神经梅毒的脑脊液Tp IgM检测也可以呈阳性结果。

Objective To explore the significance of IgM antibodies to Treponema pallidum (Tp IgM) in diagnosing neurosyphilis.Methods Using antibody capture ELISA technology,we detected Tp IgM in cerebrospinal fluid (CSF) samples of 21 patients with neurosyphilis,28 patients with syphilis and 28 patients with neurological disorders.28 cases of syphilis whose TPPA in CSF was negative and 28 cases of neurological disorders whose serum RPR and TPPA was negative were used as two control groups.Results While negative results were recorded in the two control groups,the positive rate of Tp IgM in CSF was 71.4% in neurosyphilis group.The difference was of high statistical value ( u=5.37, P <0.01).The positive rates of Tp IgM and VDRL/RPR in CSF of the neurosyphilis group were 71.4% and 33.3% respectively.The difference was of statistical value (χ 2=4.90, P <0.05).Conclusion Detection of Tp IgM in CSF is helpful in diagnosing neurosyphilis. Tp IgM in CSF may be positive in patients with asymptomatic neurosyphilis.