潜伏梅毒孕妇及其新生儿特异性IgM抗体检测分析  

Results of detection of specific Ig M antibody in pregnant women with latent syphilis and their newborns

作　　者：黄必然[1] 周姝 杨远超[1] 周潇[3] 

机构地区：[1]惠州市第一人民医院皮肤科,广东惠州516003 [2]惠州市仲恺高新区人民医院皮肤科,广东惠州5162293 [3]惠州市第一人民医院检验科,广东惠州516003

出　　处：《中国热带医学》2014年第8期962-964,共3页China Tropical Medicine

基　　金：惠州市科技项目(No.2012Y221)

摘　　要：目的探讨免疫印迹实验检测潜伏梅毒孕妇及其新生儿血清梅毒螺旋体IgM蛋白情况及其临床随访意义。方法对54例潜伏梅毒孕妇及其所生新生儿分别进行甲苯胺红不加热血清反应素试验(TRUST)、梅毒螺旋体血球凝集试验(TPHA)和梅毒螺旋体IgM蛋白免疫印迹实验(TP-IgM-WB),追踪梅毒孕妇及其新生儿梅毒感染情况。结果孕期治疗对孕妇TRUST阴转率并无影响。TP-IgM-WB经治疗后阴转率比治疗前明显提高(P<0.05),其中孕早期治疗后阴转率为35.19%,孕晚期治疗后全部阴转。TRUST低滴度(≤1:8)组TP-IgM平均阴转时间为(2.54±1.21)月,高滴度(≥1:16)组为(3.68±1.96)月,前者明显比后者短(t=5.94,P<0.01)。所生新生儿均为足月活胎,未发现先天梅毒患儿。且TRUST滴度均低于或等于母亲分娩前滴度。结论潜伏梅毒孕妇经规范驱梅治疗后能有效阻断胎传梅毒。检测抗梅毒螺旋体IgM抗体可初步推断潜伏梅毒孕妇的病程并判断其传染性,规范驱梅治疗后能快速阴转,有助于潜伏梅毒孕妇及其新生儿血清学随访。Objective To investigate the results of detection of specific IgM antibody in serum of pregnant women with latent syphilis and their newborns by Western blot. Methods Serum samples in 54 pregnant women with latent syphilis and their newborns were detected by toluidine red unheated serum reagin test （ TRUST ）, Treponema pallidum hemagglutination assay （ TPHA ）. Specific IgM antibody to Treponema pallidum was detected by Western blot （ TP-IgM-WB ）. The infectious status of syphilis in pregnant women and their newborns was traced by follow-up. Results No obvious effect of anti-syphilitic treatment of pregnant women with latent syphilis during pregnancy on the seroreversion rate of TRUST was noticed. The TP- IgM-WB negative conversion rate after treatment was higher than that before treatment （ P〈0.01）, the negative conversion rate was 35.19% after treatment in the first trimester of pregnancy, and all conversed negative in the third trimester of pregnancy. TP-IgM average negative conversion time in low titer of TRUST （≤ 1：8） group was （2.54 ± 1.21） months and that in the high titer （≥ 1：16） group was （3.68 ± 1.96） months, significant shorter of the former than that of the latter （t=5.94,P〈0.01）. All the newborns were full-term live births without showing clinical manifestations of congenital syphilis. The TRUST titer in the newborns was lower than or equal to the mothers before delivery. Conclusion Congenital syphilis can be prevented by standard treatment of pregnant women with latent syphilis. The infectious status of latent syphilis can be observed by determining the IgM antibody to Treponema pallidum. TP-IgM can converse negative quickly after antisyphilitic treatment contributing to the serological follow-up of pregnant women with latent syphilis their newborns.

关 键 词：潜伏梅毒 梅毒螺旋体 IgM 甲苯胺红不加热血清反应素试验(TRUST) 梅毒螺旋体血球凝集试验(TPHA) 蛋白免疫印迹实验(WB) 新生儿 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]