内眼手术患者血液和房水梅毒抗体检测的对比研究

Comparative study on syphilis antibody in blood and aqueous humor of intraocular operational patients

目的探讨内眼手术患者中发生梅毒的阳性率，并通过梅毒患者房水中特异性和非特异性抗体的检测，寻找梅毒是否通过房水传播的理论依据。方法对2004年以来准备接受内眼手术的4075例患者进行常规的传染四项检查，包括乙肝表面抗原（HBsAg），丙型肝炎抗体（HCV抗体），梅毒抗体（TP抗体），艾滋病抗体（HIV抗体）四项指标，并统计梅毒发生的阳性率；应用特异性抗体试验一梅毒螺旋体血球凝结试验（TPHA）和非特异性抗体试验一快速血浆反应素环状卡片试验（RPR）检测梅毒患者血清及房水中的抗体。结果4075例内眼手术患者有58例患者血液中存在梅毒抗体，阳性率1．42％。58例梅毒患者血液中TPHA阳性检出率为100％（58例），房水中为32．76％（19例）两者比较差异有统计学意义（P〈0．05）；而同组患者血液中RPR阳性检出率为51．72％（30例），房水中为8．62％（5例）两者比较差异有统计学意义（P〈0．05）。结论近年来梅毒感染阳性率相对稳定并且梅毒可能不通过房水传播。

Objective To probe the positive rates of syphilis in intraocular operational Patients, and to detect the specific and unspecific antibody in Blood and aqueous humor of syphilis Patients for providing basis of aqueous humor route of transmission of syphilis.Method 4075 patients being accepted intraocular operation from 2002 were confirmed by preoperative serological tests of these four infectious diseases including HbsAg, HCV Antibody, TP Antibody, and HIV Antibody.Infection ratio of syphilis in intraocular operational patients were analysed.The specific and unspecific antibody in blood and aqueous humor of syphilis patients was detected by rapid plasma regain circle card （RPR）and treponema pallidum gem agglutination assay （TPHA）.Result In 4075 patients being accepted intraocular operation, 58 cases patients had syphilis Antibody in blood.In the 58 cases syphilis patients blood serum, the positive ratio of TPHA was 100% （58 cases）while that ratio in aqueous humor was 32.76%（ 19 例 ）.the ratio was observed in two groups with significant difference （P 〈0.05 ）.In the same syphilis patients, the positive ratio in blood of RPR was51.72%（ 30例 ）while that ratio in aqueous humor was8.62%（5例 ）.the ratio was observed in two groups with significant difference （P 〈0.05 ）.Conclusion Recently, positive rates of syphilis infection was relatively stabilizing and the syphilis may not infect through aqueous humor.