201例感染梅毒的孕妇分娩的婴儿血清学转归分析  

Analysis of the follow-up results of syphilis serology in 201 neonetes of pregnant women with syphilis

作　　者：李宇[1] 刘意[1] 娄金丽[1] 冯霞[1] 刘宁[1] 李琴[2] 张巨 LI Yu;LIU Yi;LOU Jinli;FENG Xia;LIU Ning;LI Qin;ZHANG Ju(Beijing You'an Hospital Affiliated to Capital Medical University,Beijing 100069,China;Yanjing Medical School,Capital Medical University,Beijing 101300)

机构地区：[1]首都医科大学附属北京佑安医院临检中心,北京100069 [2]首都医科大学燕京医学院,北京101300

出　　处：《中国艾滋病性病》2018年第11期1139-1142,共4页Chinese Journal of Aids & STD

基　　金：首都医科大学基础-临床科研合作基金(16JL61)~~

摘　　要：目的评价梅毒血清学检测方法在先天梅毒患儿转归中的情况,为先天梅毒的早期排除诊断提供依据。方法收集2015年1月至2017年12月于首都医科大学附属北京佑安医院梅毒孕妇分娩并定期进行血清学随访的婴儿201例,采用非特异性抗体快速血浆反应素试验(RPR)、特异性抗体酶联免疫吸附试验(ELISA)和梅毒螺旋体明胶颗粒凝集试验(TPPA)检测并进行随访,分析转归情况;对婴儿出生时的RPR滴度与其母亲生产时的RPR滴度进行相关性分析。结果201例感染梅毒的孕妇分娩的婴儿中18例诊断先天梅毒,183例排除先天梅毒。在非先天梅毒儿的梅毒血清学检测随访中,RPR、TPPA、ELISA三种方法,转阴月龄中位数估计值分别为3、7、11个月;非先天梅毒儿出生时RPR滴度与母亲分娩时RPR滴度相关(y=1.798x+1.550,r^2=0.553,P<0.001)。结论在非先天梅毒儿的被动抗体转归中,非特异性抗体RPR转阴时间最早,特异性抗体检测TPPA转阴时间早于ELISA,联合应用TPPA和RPR可缩短排除先天梅毒儿的监测时间;非先天梅毒儿出生后首次非特异性抗体检测结果受母亲血清滴度影响。Objective To analyze the follow-up results of syphilis serology of suspected congenital syphilis,in order to provide evidence for early diagnosis of congenital syphilis.Methods The data of 201neonates born to syphilis pregnant women in Beijing You'an hospital was collected between January 2015and December 2017,and they received nonspecific antibody detection of rapid plasma reagin (RPR),specific antibody detection of treponema pallidumm particle agglutination(TPPA),and enzyme-linked immunosorbent assay(ELISA)at birth,and were followed up by 3,6,9,12and 18months old.Results Among 201infants,18were diagnosed with congenital syphilis and 183cases were not.In the follow-up of syphilis serological detection in non-congenital syphilis infants,the estimated median age of negative conversion based on detection of RPR,TPPA and ELISA was 5,7and 11months respectively.The RPR titer of non congenital syphilis was correlated with that of mothers during childbirth.Conclusion In non-congenital syphilis infants,the RPR seroconversion time is the shortest.TPPA seroconversion is earlier than ELISA.Combined use of TPPA and RPR can shorten the monitoring time to exclude congenital syphilis.The results of the first nonspecific antibody test after birth of non-congenital syphilis are affected by the maternal serum titer.

关 键 词：先天梅毒 新生儿 快速血浆反应素试验 梅毒螺旋体颗粒凝集试验 酶联免疫吸附试验 

分 类 号：R759[医药卫生—皮肤病学与性病学]