脑脊液VDRL、TRUST、IgM抗体检测对神经梅毒的诊断价值

The Value of VDRL,TRUST and IgM on Cerebrospinal Fluid to Diagnosis of Neurosyphilis

目的:通过对梅毒患者脑脊液进行非梅毒螺旋体抗体和梅毒螺旋体抗体检测结果的综合分析,探讨神经梅毒诊断的最佳检测方法,提高神经梅毒检出率。方法:采用性病研究实验室试验(VDRL)检测非梅毒螺旋体抗体,免疫印迹法(WB)检测梅毒螺旋体IgM抗体,用上述两种方法同时对280例梅毒患者脑脊液(CSF)标本进行检测。VDRL阳性者同时做甲苯胺红不加热血清试验(TRUST)。结果:280例怀疑神经梅毒患者脑脊液标本,VDRL和IgM均阳性50例;VDRL阳性IgM阴性10例;VDRL阴性IgM阳性8例。VDRL与IgM试验阳性率比较,差异无统计学意义(x^2=0.26,P>0.05);60例VDRL阳性脑脊液中TRUST试验阳性51例,两者试验阳性率结果比较,差异有统计学意义(x^2=76.1,P<0.01)。结论:对神经梅毒患者脑脊液检测,VDRL试验敏感性高于TRUST试验;对怀疑神经梅毒患者脑脊液进行VDRL和IgM联合检测,可提高神经梅毒的检出率。

Objective：To analysis the results of the non-Treponema pallidum and Treponema pallidum antibodies test, and evalutate the best method of neurosyphilis diagnosis to improve the detection rate. Methods： The Cerebrospinal Fluid （CSF） specimens from 280 cases of suspected neurosyphilis were detected by Venereal Disease Research Laboratory test （VDRL） and Western Blot （WB） first. If the result of VDRL was positive, the CSF specimen need to be confirmed by Toluidine Red Unheated Serum test （TRUST）. Results： 280 CSF samples were tested. There were only VDRL positive samples （ l0 out of 280）, only IgM positive samples （ 8 out of 280 ）, both VDRL and IgM positive samples （50 out of 280） , and the rest samples were both VDRL and IgM negative. No significant difference was observed between VDRL and IgM （ x2 = 0.26, P 〉 0.05）. There were 51 TRUST positive cases in 60 VDRL positive case, there was a significant difference between VDRL and TRUST （ x2 = 76. 1, P 〈 0. 01 ）. Conclusion： The sensitivity of CSF-VDRL was higher than CSF-TRUST in diagnosis of neurosyphilis. Combining CSF-VDRL and CSF-IgM tests can improve the detection rate of neurosyphilis.