梅毒螺旋体IgM抗体检测的临床意义

Clinical significance of detection of IgM antibody against Treponema pallidum

目的:评价检测梅毒螺旋体IgM型抗体的临床意义.方法:收集经临床确诊为梅毒患者的血清标本90例,用RT-PCR方法进行TP-DNA检测,用IgG/RF吸收剂处理血清,然后应用梅毒螺旋体明胶凝集试验进行TP-IgM的检测.结果:一期梅毒的TP-IgM抗体阳性率75.9%,二期梅毒的阳性率100%,隐性梅毒的阳性率77.8%.总阳性率为81.1%(73/90).TP-IgM在不同时期梅毒组中检测阳性率差异有统计学意义(χ2=90.20,υ=2,P<0.05).TP-DNA的检测阳性率为78.9%(71/90).TP-DNA和TP-IgM的阳性检出率统计学上无统计学差异(χ2=0.5,υ=1,P>0.05).结论:检测血清中梅毒螺旋体IgM型抗体对于梅毒的鉴别诊断具有重要的临床意义.

AIM ： To evaluate the clinical significance of detection of IgM antibody against Treponema pallidum in diagnosing syphilis. METHODS： The serum samples of 90 syphilitic patients were collected and treated with IgG/RF immunoabsorbent, then were detected for TP-IgM with Treponema pallidum particle agglutination （TPPA） assay. The serum samples were also detected for TP-DNA by RT-PCR method. RESULTS： The TPIgM positive rates were 75.9%, 100% and 77.8% in primary syphilis, secondary syphilis and latent syphilis, respectively. The total positive rate of TP-IgM was 81. 1% （73/90） in syphilis sera. The positive rates were statistically different between the 3 different syphilis groups （ χ^2= 90.20, u = 2, P 〈 0.05 ）. The TPDNA positive rate was 78.9% （71/90）. There was no significant difference between the positive rates of TP-IgM and TP-DNA （χ^2 =0. 5, u = 1, P 〉 0.05 ）. CONCLUSION： The detection of IgM antibody against Treponema pallidum in serum is important for the clinical diagnosis of syphilis.