梅毒治疗前后血中TP-DNA定量检测

A quantitative detection of plasma TP-DNA in the treatment of patients with syphilis.

目的 探讨血中梅毒螺旋体DNA(TP -DNA)定量在梅毒诊断和疗效观察中的临床价值及其治疗前后与联甲苯胺红不加热血清反应素试验 (TRUST)的关系。方法 对 2 9例 (Ⅰ期 12例 ,Ⅱ期 17例 )未经任何治疗的梅毒患者 ,用荧光定量聚合酶链式反应 (FQ PCR)检测苄星青霉素治疗前后血浆中TP DNA定量值并作血清TRUST检测。结果 ①治疗前 ,Ⅰ期TP DNA阳性率为 75 .0 0 % (9/ 12 )、TP DNA定量测定平均值为 (3.38± 2 .34)× 10 4copies/ml;Ⅱ期阳性率为 10 0 .0 0 % (17/ 17) ,TP DNA定量测定平均值为 (5 .73± 1.33)× 10 6copies/ml。②治疗后 3个月 ,Ⅰ期、Ⅱ期梅毒TP DNA阳性例数分别为 1/ 9例、5 /17例。TRUST(+)者 ,TP DNA阳性者定量平均值 :在Ⅰ、Ⅱ期分别为 2 .0 1× 10 2 copies/ml、5 .87× 10 2 copies/ml;TRUST(- )者 ,Ⅰ期无阳性病例 ,Ⅱ期为 3.0 9× 10 2 copies/ml。③治疗后 9个月 ,Ⅰ、Ⅱ期梅毒TP -DNA均为阴性 (零拷贝 ) ,TRUST转阴例数分别为 :12 / 12例、14 / 17例。结论 治疗前、治疗后 3个月、9个月TP DNA与TRUST结果并不完全一致 ,提示血浆TP

Objective To explore the relationship between quantified plasma TP DNA and TRUST test in the patients with syphilis before and after treatment and evaluate the clinical value of quantitative determination of TP DNA in the diagnosis and treatment of syphilis.Methods Twenty nine patients with primary(12 cases) and secondary(17 cases) syphilis, who met the criteria set for this study were recruited as the subjects.All the patients were treated with Benzathine penicillin 2.4 million units intramuscularly weekly for 3 weeks.Quantitative tests of TP DNA in the patients' plasma were performed using FQ PCR before and after the treatment.Serologic test including TRUST and TPPA were also performed.Results Before the treatment, 9 out of 12 primary syphilis(9/12,75%) and all the secondary syphilis patients(17/17,100%) were positive for TP DNA.The mean value of TP DNA in primary and secondary syphilis patients was ( 3.38 ± 2.34 )×10 4 copies/ml and ( 5.73 ± 1.33 )×10 6 copies/ml, respectively.At the third month after the treatment, 1 out of the 9 primary and 5 out of 17 secondary syphilis patients were positive for TP DNA respectively.The mean value of TP DNA was 2.01 ×10 2 copies/ml in primary and 5.87 ×10 2 copies/ml in secondary syphilis patients for those with positive TRUST and TP DNA test, and 3.09 ×10 2 copies/ml for those with negative TRUST ,respectively.Nine months after the treatment, all the primary and secondary syphilis patients were negative with TP DNA test, while 12/12(100%) primary and 14/17( 82.35% ) secondary syphilis patients showed negative TRUST test.Conclusion That the results of TP DNA test were not consistent with those of TRUST before and after teatment indicated that quantitative determination of TP DNA may have some clinical significance in the early diagnosis and effectiveness evaluation for syphilis.