FQ-PCR对一期、二期梅毒诊断价值的初步探讨

Study of syphilis serological test on the diagnosis of primary and secondary syphilis by fluorescence quantitative PCR

目的探讨荧光定量聚合酶链反应(FQ-PCR)检测一期、二期梅毒皮疹组织液的诊断价值。方法选择2016年12月-2018年10月该院门诊收集的134例疑似梅毒患者,于纳入后次日清晨抽取5ml静脉血送至实验室,进行RPR、TPPA检查;同时收集皮疹组织液,进行FQ-PCR检查。2个月后对所有入组患者再次梅毒血清学检查。结果共诊断67例早期梅毒。其中,一期梅毒41例,入组时FQ-PCR、梅毒血清学检查敏感性分别为95.12%(39/41)、78.05%(32/41),两组敏感性有显著性差异(P<0.05);二期梅毒26例,入组时FQ-PCR、梅毒血清学检查敏感性分别为61.54%(16/26)、100%(26/26),两组敏感性有显著性差异(P<0.05)。FQ-PCR特异性为97.01%(65/67)。结论FQ-PCR对一期梅毒敏感性、特异性均较高。当怀疑一期梅毒而梅毒血清学检查阴性时,FQ-PCR可作为一个替代诊断方法使用。

Objective To investigate the diagnostic value of fluorescence quantitative polymerase chain reaction(FQ-PCR)in the detection of primary and secondary syphilitic rash tissue fluid.Methods From December 2016 to October 2018,5ml of venous blood was collected from 134 suspected syphilis outpatients of the hospital and sent to the laboratory for RPR and TPPA detection in the next morning;the tissue fluid of skin lesions was collected for FQ-PCR detection.Results Sixty seven cases of early syphilis were diagnosed.Among 67 cases of early syphilis,41 cases were diagnosed as primary syphilis.According to primary syphilis,the sensitivity of FQ-PCR and syphilis serological test when included were 95.12%(39/41)and 78.05%(32/41),respectively,and there was a significant difference in sensitivity between the two groups(P<0.05).According to secondary syphilis,and the sensitivity of FQ-PCR and syphilis serological test when included were 61.54%(16/26)and 100%(26/26),respectively,and there was a significant difference in sensitivity between the two groups(P<0.05).Specimens from all non-syphilis patients except two were negative for FQ-PCR,with a specificity of 97.01%(65/67).Conclusion The sensitivity and specificity of FQ-PCR were high for primary syphilis.FQ-PCR may be used as an alternative diagnostic method especially when syphilis is suspected to be primary but syphilis serological test is negative.