摘要
目的探讨血清IgM抗体在梅毒早期诊断及传染性方面的临床应用价值。方法收集2010年9月-12月在北京协和医院皮肤科性病中心就诊的梅毒患者36例,男24例,女12例,年龄16～76岁,平均(42±14)岁,所有病例均经快速血浆反应素环状卡片试验(RPR)和梅毒螺旋体明胶凝集试验(TPPA)确诊;使用梅毒螺旋体IgM抗体蛋白印迹试验检测上述36例患者血清,比较不同分期,不同RPR滴度患者之间阳性率的差别。结果 IgM的出现与RPR滴度及分期具有相关性,在RPR滴度≥1:8的梅毒患者中检出率明显升高,为82.35%(14/17),而潜伏梅毒IgM检出率20.00%(2/10)较二期梅毒69.23%(18/26)低。在血清抵抗的梅毒患者中,未发现IgM抗体阳性的病例。年龄、性别、是否治疗对IgM检出率没有明显影响。结论梅毒螺旋体IgM抗体的检出提示梅毒螺旋体的近期感染或复发;梅毒血清抵抗的患者基本没有传染性。
Objective To evaluate the clinical utility of testing serum anti-treponema pallidum IgM antibody in the diagnosis of early stage syphilis and its infectivity. Methods Over a period of g months （ September-December 2010） ,36 patients with acquired syphilis （24 men and 12 women）, aged 16 N 76, mean age （42 ± 14） years old, attending the sexually transmitted disease clinic of peking union medical college hospital were included in the study. Definite diagnosis was based on the results of rapid plasma regain （RPR） and Trepone- ma pallidura passive particle agglutinating assay （TPPA） ; we detected antitreponemal IgM antibodies in the serum of the 36 patients with different stages of syphilis to characterize its distribution in different RPR titres and stages of syphilis. Results The detectivity of IgM antitreponemal antibodies correlated with RPR titres and stages of syphilis. It was inclined to be detected when RPR titres were higher than 1：8 （14/17） and when it was at the secondary stage of disease （18/26）. Persons with latent syphilis had faint IgM responses （2/10） compared with secondary syphilis. Treponema pallidum-specific IgM antibodies were not detected and were either negative or equivocal in syphilis patients with seroresistance. We found no statistically signif- icant difference among different age and sex groups, nor did treatment appear to have any influence on IgM positive rate,which one would like to believe that effective treatments would decrease the detection of IgM. Conclusion The detection of antitreponemal IgM antibodies demonstrated recent infection and relapse; it＇ s uninfectious in seroresistance syphilis patients.
出处
《中国皮肤性病学杂志》
CAS
北大核心
2012年第7期591-593,610,共4页
The Chinese Journal of Dermatovenereology
