不同血清学抗体检测结果在梅毒分期中的应用

Application of serological antibody detection results in syphilis patients at different stages

目的了解梅毒特异性IgM抗体、梅毒特异性IgG抗体、梅毒非特异性抗体等在不同分期梅毒患者的检测意义。方法采用蛋白印迹法(WB)检测梅毒特异性抗体IgM、梅毒螺旋体颗粒凝集试验(TPPA)检测梅毒特异性IgG抗体和甲苯胺红不加热血清试验(TRUST)检测梅毒非特异性抗体,对110例各期(一期、二期、隐性等)梅毒患者进行检测分析。结果检测的110例梅毒患者,其中一期梅毒患者IgM-WB、TPPA和TRUST的阳性率分别为28/44、27/44和16/44;二期梅毒患者IgM-WB、TPPA和TRUST的阳性率分别为11/19、19/19和19/19;隐性梅毒患者IgM-WB、TPPA和TRUST的阳性率分别为9/47、46/47和40/47。结论梅毒特异性IgM抗体在一期梅毒患者检测中能更早明确诊断,而梅毒特异性IgG抗体和梅毒非特异性抗体在二期梅毒和隐性梅毒患者检测中具有更高的准确率,多种抗体联合检测对不同分期的梅毒诊断提供更为可靠依据。

Objective To evaluate the detection significance of Treponema pallidum specific IgM antibody,Treponema pallidum specific IgG antibody,and Treponema pallidum non-specific antibody in patients with different stages of syphilis.Methods Blood samples from 110 syphilitic patients at different stages(phase I,phaseⅡ,recessive,etc.)were collected.Western blot method(WB)was used to detect syphilitic specific antibody IgM,Treponema pallidum particle agglutination test(TPPA)to detect syphilitic specific antibody IgG and toluidine red unheated serum test(TRUST)to detect Treponema pallidum nonspecific antibody.Results The positive rates of IgM-WB,TPPA and TRUST in 110 syphilis patients were 28/44,27/44 and 16/44,respectively.The positive rates of IgM-WB,TPPA and TRUST in patients with secondary syphilis were 11/19,19/19 and 19/19,respectively.The positive rates of IgM-WB,TPPA and TRUST in patients with latent syphilis were 9/47,46/47 and 40/47,respectively.Conclusion Treponema pallidum specific IgM antibody can be detected earlier in the patients with primary syphilis,while Treponema pallidum specific IgG antibody and Treponema pallidum non-specific antibody have higher accuracy rates in the detection of secondary syphilis and recessive syphilis.The combined detection of multiple antibodies provides a more reliable basis for the diagnosis of different stages of syphilis.