血清抗核抗体谱在梅毒诊断中的临床研究

Clinical research of serum antinuclear antibody spectrum in the diagnosis of syphilis

目的：评价血清抗核抗体谱（ANAs）在梅毒诊断中的临床意义。方法：对220例梅毒明胶颗粒凝集试验（TPPA）阳性者和220例TPPA阴性的健康体检者采用免疫印迹法检测ANAs。结果：220例TPPA阳性者中,SSA阳性24例（10.9%）;Ro-52阳性37例（16.8%）;DsDNA阳性8例（4.0%）;PCNA阳性16例（7.2%）;Po阳性7例（3.2%）;SSB阳性17例（7.7%）。所有ANAs阳性率显著高于健康对照组（P〈0.01）。TRUST阳性与阴性患者相比,ANAs阳性率无显著差异（P〉0.05）。女性的SSA、Ro-52和SSB的阳性率明显高于男性（P〈0.05）。45岁以下TPPA阳性者ANAs阳性率较低,46～75岁TPPA阳性者ANAs阳性率有逐渐增高的趋势。结论：感染梅毒可能增加自身免疫病的风险,检测ANAs有利于评估和防治梅毒感染患者免疫损伤,减少自身免疫病的发生,但对梅毒的临床诊断参考意义不大。

Objective：To assess the clinical significance of antinuclear antibody spectrum（ANAs） in the diagnosis of syphilis.Methods：Serum ANAs were detected among 220 patients with positive treponema palladium particle assay（TPPA） and 200 healthy persons with negative TPPA.Results：Among the patients with positive TPPA SSA was positive in 24 patients（10.9%）：The positive rates of Ro-52,DsDNA,PCNA,Po and SSB were 16.8%,4.0%,7.2%,3.2%and 7.7%,respectively.All the antibodies of ANAs were significantly higher in the patients with positive TPPA than in the healthy controls（P〈0.01）.There was no significant difference（P〉0.05） in the positivity of ANAs among the patients with positive TRUST and among the patients with negative TRUST.The positive rates of SSA,Ro-52 and SSB were higher in females than in males.The positive rates among those younger than 45 years were relatively low,and increased with age among those older than 45 years.Conclusion：Syphilis infection may increase the risk of autoimmune diseases.ANAs detection may be useful to evaluate the risk of autoimmune disease among the patients with syphilis infection,although there is no diagnostic significance.