女性梅毒患者血清 尿液及阴道分泌物梅毒螺旋体DNA的检测分析

Detection and analysis of TP-DNA in serum,urine and vaginal secretion in the women with syphilis

目的探讨女性梅毒患者经规范治疗前后,血清、尿液及阴道分泌物的梅毒螺旋体脱氧核糖核酸(TPDNA)含量,观察其泌尿、生殖道感染的情况,评估其体液的间接传染性。方法选取2015年1-12月,规范治疗前后女性梅毒患者110例,用荧光定量聚合酶链反应检测其血清、尿液及阴道分泌物TP-DNA,同时进行梅毒螺旋体抗体快速血浆反应素试验(RPR)。结果梅毒女性患者不同临床分期血清、尿液、阴道分泌物阳性率差异均有统计学意义(P<0.05);女性梅毒患者经规范治疗前,其血清、尿液及阴道分泌物TP-DNA阳性率分别为36.36%、7.27%、10.91%,治疗后分别为12.73%、0.91%、1.82%,差异均有统计学意义(P<0.05);两组组内血清、尿液及阴道分泌物中的TP-DNA阳性率之间比较差异均有统计学意义(P<0.05);女性梅毒患者经规范治疗后,RPR无明显变化组血清TP-DNA阳性率为21.43%,高于治疗有效组血清TP-DNA检测阳性率(3.70%),差异有统计学意义(P<0.05);将女性梅毒患者按照血清RPR滴度分为1∶2、1∶4~1∶8和1∶16三组,比较三组血清、尿液、阴道分泌物的TP-DNA阳性率,结果各组TP-DNA阳性率差异均有统计学意义(P<0.05)。血清TP-DNA阳性率与血清RPR滴度呈正相关(r=0.710,P<0.05)。结论女性梅毒患者的血清、尿液、阴道分泌物中存在梅毒螺旋体,治疗后仍有部分血清、尿液及阴道分泌物中检出TP-DNA阳性,体液也是梅毒的间接传染源。

Objective To study the level of treponema pallidum（TP） DNA of women with syphilis before and after standard treatment, and to observe the infection status of urinary tract to evaluate the indirect infectivity of body fluid. Methods 110 women with syphilis were chosen from January to December 2015. TP-DNA was detected with fluorescence quantitative polymerase chain reaction （FQ-PCR）, including the rapid plasma reagin assay （RPR）. Results There was significant difference in the positive rates of TP-DNA in serum, urine and vaginal secretion of the women with syphilis on different clinical stages （P〈0.05）. Positive rate of TP-DNA in serum, urine and vaginal secretion on the women before standard treatment was 36.36%, 7.27% and 10.91% respectively, significantly higher than the patient after treatment （12.73 %, 0.91%, and 1.82 % respectively） with significant difference in the positive rates of TP-DNA in serum, urine and vaginal secretion （P〈0.05）. After standard treatment, the group of no obvious change in RPR had 21.43% positive rate of TP-DNA in serum, which was significantly higher than the group of effective treatment （P〈0.05）, with 3.70% positive rate of TP-DNA. Groups divided based on RPR titer of serum, had positive correlations between the positive rate of TP-DNA in serum and RPR titer （r = 0. 710, P〈 0.05） with significant difference. Conclusion TP is detected in the serum, urine and vaginal secretion of women with syphilis, and even after treatment. It implies that body fluid is the indirect source of infection of syphilis.