潜在血源传播梅毒患者血清抵抗特性分析  

Characteristics of serologic resistance in syphilis patients with latent blood-transmitted risk

作　　者：林丽蓉[1] 童曼莉[2] 付左根[2] 但冰[2] 杨天赐[1] 

机构地区：[1]厦门大学附属中山医院临床检验中心,福建厦门361004 [2]厦门大学医学院基础部,福建厦门361005

出　　处：《中华医院感染学杂志》2011年第6期1154-1156,1241,共4页Chinese Journal of Nosocomiology

基　　金：福建省自然科学基金(2009J01200);福建省科技计划重点项目(2009D019);厦门市科技计划(3502z20089015)

摘　　要：目的研究潜在血源传播梅毒患者血清抵抗特性,探讨其传染性和复发的血清学指标。方法在回顾性分析2005年6月-2009年5月厦门大学附属中山医院收治的714例潜在血源传播梅毒患者的血清抵抗特性基础上,采用荧光密螺旋体抗体吸收试验(FTA-ABS)进行梅毒特异性IgM抗体(TP-IgM)检测。结果 714例潜在血源传播梅毒患者中,有242例患者经1年梅毒规范治疗后,其反应素仍保持阳性,血清抵抗率33.89%,其中男性患者血清抵抗率28.08%,显著低于女性患者(40.54%),差异有统计学意义(χ2=12.306,P<0.05);不同检测年度、不同年龄患者血清抵抗率差异无统计学意义;采用FTA-ABS法,242例血清抵抗患者中检出TP-IgM的阳性率为32.23%,显著高于梅毒血清治愈组(10.70%)和献血员组(0)。结论潜在血源传播梅毒患者有着较高的血清抵抗率,是梅毒治疗失败的重要表现,并容易复发和具有传染性,TP-IgM可作为其复发和具有传染性的血清学指标。OBJECTIVE To study the characteristics of the syphilis serologic reaction in syphilis patients with latent blood-transmitted risk,and explore wheather it can be taken as a serologic marker for relapse and infection of syphilis.METHODS The characteristics of the syphilis serologic reaction from 714 cases of syphilis patients with latent blood-transmitted risk were retrospectively analyzed.All sera samples were collected from Zhongshan hospital,Xiamen University from Jun 2005 to May 2009.Treponema pallidm（TP） specific IgM antibody（TP-IgM） was detected with fluorescent treponemal antibody-absorption（FTA-Abs）.RESULTS Among the 714 patients who received recommended therapy for syphilis,242 cases were still tested positive in nontreponemal antibody the prospective one year,with a syphilis serologic reaction incidence of 33.89%.The incidence of male patients（28.08%） was lower than that of the female patients（40.54%）,there was a significant difference according to gender（χ^2=12.306;P〈0.05）.There was no significant difference in the incidence of serologic reaction among patients according to the annum and age.78 cases out of 242 patients with serologic reaction were TP-IgM-positive by FTA-Abs,the positive rate（32.23%） of which was markedly higher than that in serum cure group（10.70%）.CONCLUSION Syphilis patients with latent blood-transmitted risk have higher incidence of serologic reaction,which is the important manifestations of treatment failure.Therefore,TP-IgM could be taken as a serologic marker for relapse and infection of syphilis.

关 键 词：潜在血源传播 梅毒 患者 血清抵抗 梅毒甲苯胺红不加热血清反应素试验 梅毒特异性IgM抗体 

分 类 号：R181.32[医药卫生—流行病学]