聚合酶链反应检测梅毒螺旋体的进展  

Application of polymerase chain reaction in detection of Treponema Pallidium： an update

作　　者：叶兴东[1] 林宏达[2] 戴向农[1] 任泽舫[2] 

机构地区：[1]广州市皮肤病防治所,6510095 [2]中山大学公共卫生学院医学统计与流行病学系

出　　处：《国际皮肤性病学杂志》2016年第1期19-22,共4页International Journal of Dermatology and Venereology

基　　金：广东省科技计划项目（20128031800014）;广州市科技攻关项目（201300000166）;广州市医药卫生科技项目（20121A031001）

摘　　要：梅毒是由苍白螺旋体感染引起的一种常见系统性性传播疾病,早诊早治梅毒有利于减少传播、减轻系统损害.直接暗视野检查苍白螺旋体或血清抗体检测是诊断梅毒的主要手段,但有局限性.聚合酶链反应通过扩增苍白螺旋体靶序列诊断梅毒,而polA、tpp47基因为聚合酶链反应法检测苍白螺旋体常用靶基因.反转录聚合酶链反应和巢式聚合酶链反应的敏感性高于其他聚合酶链反应法.聚合酶链反应法检测一期梅毒拭子中苍白螺旋体敏感性可达60％以上,而检测血液及脑脊液苍白螺旋体敏感性不超过60％（胎传梅毒可达83％）,特异性93％以上.患者HIV感染与聚合酶链反应检测敏感性无关.Syphilis is a chronic and systemic sexually transmitted disease caused by Treponema pallidium （TP）.Early diagnosis and treatment are helpful in reducing spread of syphilis and in attenuating systemic damage.Direct detection of TP by dark-field microscopy （DFM） and serological tests for antibodies have been the main diagnostic means for syphilis, but they both have limitations.Polymerase chain reaction （PCR） techniques are currently applied in the diagnosis of syphilis by amplifying target sequences of TP, and polA and tpp47 genes are the commonest target sequences for the detection of TP with PCR.Reverse transcription PCR and nested PCR show higher sensitivity than other PCR techniques.The sensitivity of PCR techniques is above 60% for detection of TP DNA in swab samples from primary syphilis lesions, less than 60% in blood and cerebrospinal fluid samples （up to 83% in samples from patients with congenital syphilis）.However, the specificity of PCR techniques is usually above 93% for the detection of TP.HIV status does not influence the sensitivity of PCR techniques.

关 键 词：梅毒 苍白密螺旋体 聚合酶链反应 诊断 基因 

分 类 号：R759.1[医药卫生—皮肤病学与性病学] R440[医药卫生—临床医学]