早期先天梅毒几种实验室诊断方法的评价

Evalution of detection of serum IgM Treponema pallidum by several methods in the diagnosis of early congenital syphilis

目的评价梅毒螺旋体蛋白印迹试验(TPPA-IgM-WB)和梅毒螺旋体19(s)-IgM酶联免疫吸附法[TP-19(s)-IgM-ELISA]在先天梅毒早期诊断中的作用。方法对45例梅毒孕妇所产46例(1例双胞胎)新生儿运用血清IgM-WB试验、梅毒螺旋体19(s)-IgM酶联免疫吸附法[TP-19(s)-IgM-ELISA]和常规血清学方法(TPPA、RPR、FTA-ABS-IgM)检测,评价上述试验诊断方法在先天梅毒早期诊断中的作用。结果45例梅毒孕妇所生的新生儿中,按常规综合诊断方法21例确诊为先天梅毒,新生儿血清IgM蛋白印迹试验23例阳性,梅毒螺旋体19(s)-IgM酶联免疫吸附法24例阳性(21例常规方法诊断为先天梅毒)。30例作为对照的非梅毒孕妇及新生儿各项检查均为阴性。结论血清IgM蛋白印迹试验和梅毒螺旋体19(s)-IgM酶联免疫吸附法[TP-19(s)-IgM-ELISA]诊断先天梅毒具有较高的特异性和敏感性,结果显示可能高于现行的常规综合诊断方法的诊断价值。

Objective To evaluate the effects of TPPA-IgM-WB and TP-19（s）-IgM-ELISA in the detection of Treponema pallidum IgM for diagnosis of congenital syphilis.Method Methods of TPPA-IgM-WB,TP-19（s）-IgM-ELISA,FTA-ABS-IgM,TRUST and TPPA were used simultaneously to test sera of 46 neonates born to 45 women with syphilis.Result Positive TP-19（s）-IgM-ELISA（including 21 congenital syphilis） were observed in 24 out of the 46 serum specimens from syphilitic women;23 positive serum IgM were detected by Western blot（21 congenital syphilis）.No positive results were observed in the 30 infants from healthy mothers.Conclusion TPPA-IgM-WB and TP-19（s）-IgM-ELISA are sensitive and specific in identification of symptomatic treponema pallidum infected infants.The diagnostic value of TPPA-IgM-WB and TP-19（s）-IgM-ELISA in detection of Treponema pallidum serum IgM is superior to any one of the conventional methods.