老年白内障患者血清房水与泪液梅毒螺旋体DNA检测价值研究

The application of setecting treponema pallidum DNA in aqueous humor by FQ-PCR among senile cataract patients

目的探讨老年白内障患者梅毒螺旋体感染的特点及应用价值。方法回顾性临床病例分析研究。选取潍坊医学院附属医院在2009年1月至2011年1月收治的老年白内障患者为研究对象，首先进行ELISA梅毒螺旋体抗体筛查，阳性标本进行TPPA确证，对确证阳性患者血清、房水与泪液进行荧光定量PCR梅毒螺旋体DNA检测。结果在梅毒螺旋体抗体阳性老年白内障患者中，检测54例血清，梅毒螺旋体DNA12例阳性，阳性率23．08％；检测50例房水，梅毒螺旋体DNA阳性4例，阳性率8％；检测46例泪液，梅毒螺旋体DNA阳性3例，阳性率6．52％。抗体阳性老年白内障患者血清、房水与泪液梅毒螺旋体DNA检测阳性率差异有统计学意义（χ2=7．0021，P〈0．05），房水与泪液梅毒螺旋体DNA阳性率差异无统计学意义（χ2=0．0141，P〉0．05），血清梅毒螺旋体DNA阳性率明显高于房水与泪液（χ2=6．9854，P〈0．05）。结论老年白内障患者梅毒螺旋体感染多表现为隐性梅毒或潜伏梅毒，不是术后出现葡萄膜炎的确切病因。

Objective To explore the characteristics and application value of the infection of treponema pallidum among age-related cataract patients. Methods The age-related cataract patients hospitalized in Affiliated Hospital of Weifang Medical University in the period between Jan. 2009 and Jan. 2011 were undertaken. The first step was detecting the treponema pallidum antibodies of the patients by ELISA assay, and those positive samples were confirmed by TPPA. Then the serum, aqueous humor and tears of those confirmed positive were collected and tested by fluorescence quan- titative PCR treponema pallidum DNA testing. Results Tewlve patients＇ treponema pallidum antibod- ies were positive among 54 patients＇ serum, and the positive rate was 3.26%, 4 patients＇ were posi- tive among 50 patients＇ aqueous humor, and 3 patients＇ among 46 patients＇ tears. The positive rate was 23.08%, 8% and 6.52%, respectively. There were significant difference among these three groups （χ2=7.0021, P 〈0.05）. But it showed no significant differences of positive rate of treponema pallidum DNA between aqueous humor and tears （χ2=0.0141, P 〉0.05）. Besides, the positive rate of treponema pallidum DNA in serum were significantly higher than that in aqueous humor and tears （χ 2=6.9854, P 〈0.05）. Conclusions The age-related cataract patients with the infection of treponema pallidum perform recessive syphilis and latent syphilis mostly. And it is not the exact cause for uve- itis after operation.