梅毒血清固定与梅毒螺旋体tpr基因亚型关系的初步研究  

Relationship between seroresistance and molecular subtypes of treponema pallidum repeat gene

作　　者：杨文林[1] 林文生[1] 杨健[1] 郑和平[2] 

机构地区：[1]广州医学院第二附属医院,广东广州510260 [2]广东省皮肤性病防治中心,广东广州510095

出　　处：《中国现代医学杂志》2011年第16期1821-1825,共5页China Journal of Modern Medicine

基　　金：广东省科技计划项目(No:2008B030301249)

摘　　要：目的研究梅毒螺旋体(TP)的tpr基因亚型分布,探讨梅毒血清固定与TPtpr基因亚型的关系。方法收集广州地区多家医院确诊为早期梅毒且未经治疗的初诊患者标本102份,其中全血75份,溃疡分泌物27份,用巢式PCR扩增TP基础膜蛋白基因(bmp),阳性者再用巢式PCR扩增TPtpr基因,酶切后用限制性片段长度多态性方法(RFLP)对TP菌株进行tpr基因分型;追踪正规驱梅治疗后12个月患者的血清TRUST滴度变化,分析tpr基因亚型与患者血清TRUST滴度变化的关系。结果剔除失访病例后的86份(86/102)有效标本中,巢式PCR筛选TP阳性者48份(55.8%),成功进行tpr基因分型者40份,分出3个tpr基因亚型,其中d亚型28份,e亚型4份,i亚型8份;正规驱梅治疗后12个月,有33例(33/40)患者血清TRUST转阴,其中25例d亚型、4例i亚型及4例e亚型,7例(7/40)患者的血清TRUST滴度不转阴,包括3例d亚型和4例i亚型。结论 TPtpr的d亚型是广东地区梅毒螺旋体的优势流行株(70%),血清固定的形成可能与TPtpr基因的i亚型相关。[Objective] To study the molecular epidemiological feature of subtypes of Treponema Pallidum repeat（tpr） gene in Guangzhou area and investigate the relationship between the ＂seroresistance＂ and molecular subtypes of tpr gene.[Methods] 102 specimens of confirmed patients with untreated early syphilis,including 75 specimens of whole blood and 27 specimens of ulcer secretions,were collected by multiple centers cooperation in Guangzhou.Treponema Pallidum basic membrane protein（bmp） genes were screened from these specimens by nested PCR.The positive specimens were amplified with the primers of tpr gene.The amplified products were typed by restriction fragment length polymorphism（RFLP）.The patients with early syphilis were followed up for 12 months and the serum titers of TRUST were tested.After standard treatment,the relationship between the change of serum TRUST titer of the patients and the subtypes of tpr gene were analyzed.[Results] Treponema pallidum DNA were found in 48 specimens of genital lesions secretions and whole blood,from 86 valid patients with primary syphilis.Forty of 48 had typeable DNA.Three molecular subtypes were found,including subtype d（28）,e（4）,and i（8）.The serum titer of TRUST became negative in 33（33/40） patients 12 months after therapy,7 patients occurred seroresistance which include 3 subtype d and 4 subtype i.[Conclusions] Treponema pallidum tpr subtyped are the predominant strain in Guangzhou area,it was suggested that the seroresistance be related with Treponema pallidum tpr subtype i.

关 键 词：梅毒螺旋体 血清固定 聚合酶链式反应 限制性片段长度多态性 分子亚型 

分 类 号：R759[医药卫生—皮肤病学与性病学]