疑似先天梅毒新生儿血浆梅毒螺旋体DNA定量检测及随防  

Ratio detection of Treponema pallidum DNA in plasma of suspected congenital syphilis

作　　者：鲁东平[1] 沈全才 秦琴[3] 付敏 杨鹏 张荣[1] 李湘辉[1] 贾婕[1] 

机构地区：[1]深圳市宝安区慢性病防治院皮肤科,广东深圳518133 [2]深圳市宝安区松岗人民医院急诊科,广东深圳518105 [3]深圳市宝安区人民医院皮肤科,广东深圳518133 [4]深圳市宝安区沙井人民医院,广东深圳518104 [5]深圳美莱医疗美容医院

出　　处：《中国热带医学》2015年第12期1445-1447,1451,共4页China Tropical Medicine

基　　金：深圳市宝安区科技计划-社会公益项目(No.2013095)

摘　　要：目的探讨荧光定量PCR（FQ-PCR）方法在疑似先天梅毒随访中的价值。方法 60例疑似先天梅毒病例在出生后的1月内,行血浆FQ-PCR、甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶凝集试验（TPPA）、19S-IgM-TP-PA（只做一次）检测。在3、6、9、12、15、18月龄时进行血浆TP DNA、血清学TRUST和TPPA随访,当TRUST和TPPA均阴性时,则终止随访。采用SPSS18.0软件对检测结果进行统计分析。结果 60例疑似先天梅毒新生儿1月龄时,TRUST阳性的有51例,滴度均≤1：4;TPPA均阳性;19S IgM-TPPA均阴性。疑似先天梅毒新生儿中,阳性病例的TPDNA拷贝量在10^2～10^3copies/mL。三种方法的检测结果在1、3、6、9月龄时的总阴转率有明显差异（P〈0.05）;在1、3月龄时FQ-PCR总转阴率最高,分别为75.00%、96.67%;6月龄时FQ-PCR和TRUST检测全部阴转;TPPA在1、3、6、9月龄总阴转率最低,12月龄全部阴转。结论 FQ-PCR定量检测血浆中TP DNA是一种敏感的方法,可应用于疑似先天梅毒的随访。Objective To investigate the application utility of fluorescence quantitative PCR（FQ- PCR）test in thesuspected congenital syphilis during following- up. Methods A total of 60 cases of suspected congenital syphilis wereinvolved in this study. Their plasma were detected by FQ-PCR,and serum were detected by toluidine red unheated serum test（TRUST）,Treponema pallidum gelatin agglutination test（TPPA）and 19 s IgM-TPPA（only once）within 1 month of age. Thenthe newborns were followed up at 3,6,9,12,15,and 18 months of age until they were turned negative with TRUST and TPPA.The results were statistically analyzed by SPSS18.0. Results In the 60 cases of suspected congenital syphilis newborns at 1month of age,of which 51 of them were TRUST positive,with titer≤1：4,TPPA with positive and 19 s IgM-TPPA with allnegative. The TP DNA of the positive cases were 10^2～10^3copies/mL;The total turned negative rates were significantly different（P〈0.05）at the 1,3,6,and 9 months of age,by the detection of the three methods; The plasma TP DNA had the highest turnednegative rate,were 75% and 96.67% at 1,3 months of age,TP DNA and TRUST results were all turned negative at 6 months ofage,TPPA results all became negative at 12 months of age,and had the lowest turned negative rate at the 1,3,6,and 9 monthsof age. Conclusion As a very sensitive method,FQ-PCR is used to detect TP DNA in plasma,which can be used in thefollow-up of the suspected congenital syphilis.

关 键 词：疑似先天梅毒 新生儿 血浆 荧光定量PCR 阴转时间 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]