TP-IgM-WB在成人早期梅毒诊断中的应用

Application of TP-IgM-WB in Diagnosis of Early Syphilis in Adults

目的探讨梅毒螺旋体蛋白印迹试验(TP-IgM-WB)对于成人早期梅毒诊断的意义。方法使用梅毒螺旋体蛋白免疫印迹试验(TP-IgM-WB)、梅毒螺旋体明胶颗粒凝集试验(TPPA)、甲苯胺红不加热血清试验(TRUST)对2016年1月—2017年12月到该所性病门诊就诊的109例成人梅毒患者进行检测,另外选取100例非梅毒患者作为观察对照组,对比分析3种方法在梅毒患者中的阳性检出率。结果 28例一期梅毒中,TP-IgM-WB、TPPA、TRUST检测阳性数分别为28例(100.0%)、26例(92.9%)、25例(89.3%),3种方法阳性检测率差异无统计学意义(P>0.05);37例二期梅毒中,TP-IgM-WB、TPPA、TRUST检测阳性数都是37例(100%);44例潜伏梅毒中,TPIgM-WB、TPPA、TRUST检测阳性数分别为40例(90.9%)、44例(100.0%)、42例(95.5%),3种方法阳性检测率差异无统计学意义(P>0.05);100例非梅毒患者TP-IgM-WB和TPPA检测阳性数是0例(0.0%),TRUST检测阳性数2例(2.0%),3种方法阳性检测率差异无统计学意义(P>0.05)。TP-IgM-WB在一期梅毒患者中阳性检出率大于TPPA和TRUST两种方法。结论梅毒螺旋体蛋白印迹试验适用于成人早期梅毒的诊断,对于早期发现梅毒患者,早期治疗并进行患病人群干预,有效控制梅毒流行都具有重要意义。

Objective To explore the significance of TP-IgM-WB in diagnosis of early syphilis in adults. Methods 109 cases of syphilis patients from January 2016 to December 2017 in our STD clinic were tested by using Treponema pallidum IgM Western blot（TP-IgM-WB）, Treponema pallidum gelatin particle agglutination test（TPPA） and toluidine red unheated serum test（TRUST）, and 100 non-syphilis patients were chosen as a control group. The positive rate of three methods for syphilis patients was compared and discussed. Results The positive cases tested by TP-IgM-WB. TPPA and TRUST in 28 cases of primary syphilis were 28 cases（100.00%）, 26 cases（92.9%）, 25 cases（89.3%）, There is no statistical significance in the positive rate of the three methods（ P〉 0.05）; the positive cases of TP-IgM-WB, TPPA and TRUST in 37 cases of secondary syphilis all were 37 cases（100.00%）; the positive cases of TP-IgM-WB,TPPA and TRUST in 44 cases of latent syphilis were 40 cases（90.9%）, 44 cases（100.00%）, 42 cases（95.5%）. There was no statistical significance in the positive rate of the three methods（P〉 0.05）; the positive cases of TP-IgM-WB and TPPA in 100 cases of non-syphilis patients was 0 cases（0.0%）, the positive case of Trust is 2 cases（2.0%）. There is no statistical significance in the positive rate of the three methods（P〉 0.05）.The positive test rate of TP-IgM-WB in patients with primary syphilis was greater than that of TPPA and TRUST. Conclusion Treponema pallidum IgM Western blotting test is suitable for the diagnosis of primary syphilis in adults. It is of profound significance to the early detection of syphilis,early treatment and intervention of the affected population, and effective control of syphilis epidemic.