血清学监测228例早期梅毒患者治疗效果的价值评估  

The assessment of serological tests for the therapeutic effects in 228 patients with early syphilis

作　　者：田晓波[1] 潘书娟[3] 李娅娣[2] 王娜[1] 鲁辛辛[1] 

机构地区：[1]首都医科大学附属北京同仁医院检验科,100176 [2]首都医科大学附属北京同仁医院皮肤科,100176 [3]北京中医药大学东直门医院东区检验科

出　　处：《中华传染病杂志》2017年第7期411-414,共4页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金（81371861）

摘　　要：目的评估梅毒螺旋体明胶凝集试验（TPPA）和梅毒甲苯胺红不加热法（TRUST）对早期梅毒治疗效果的诊断价值。方法2012年1月至2016年10月首都医科大学附属北京同仁医院皮肤科189例早期梅毒患者，以及39例3个月内有危险史但无临床症状的患者。于治疗前和治疗第3、6、12个月行TPPA和TRUST检测。组间比较采用χ^2检验。结果治疗前和治疗后12个月内，228例早期梅毒患者血清TPPA均为阳性。治疗前225例患者TRUST阳性，治疗12个月后有156例患者转阴，转阴率为69.3%。将治疗前TRUST滴度≤1∶4设为低滴度组，≥1∶8为高滴度组。治疗前TRUST低滴度组93例，3例阴性，90例滴度为1∶1～1∶4；高滴度组135例。治疗3个月TRUST转阴患者27例，低滴度组转阴率为19.35%（18/93），高滴度组转阴率为6.67%（9/135），两组比较差异有统计学意义（χ^2＝7.10，P〈0.01）。治疗后6个月TRUST转阴患者62例，滴度为1∶1～1∶4的低滴度组患者转阴率为36.56%（34/93），高滴度组患者转阴率为11.85%（16/135）；滴度≥1∶8的低滴度组患者转阴率为6.45%（6/93），高滴度组患者转阴率为4.44%（6/135），两组比较差异有统计学意义（χ^2＝17.10，P〈0.01）。治疗后12个月TRUST转阴患者67例，滴度为1∶1～1∶4的低滴度组患者转阴率为23.66%（22/93），高滴度组转阴率为14.81%（20/135）；滴度≥1∶8的低滴度组患者转阴率为1.08%（1/93），高滴度组转阴率为17.78%（24/135），两组比较差异无统计学意义（χ^2＝1.15，P〉0.05）。结论血清学试验结合临床体征，可以准确地对早期梅毒进行诊断，且对治疗效果做出有效的评估。ObjectiveTo evaluate the diagnostic value of treponema pallidum particle agglutination （TPPA） and toludine red unheated serum test （TRUST） for the therapeutic effects of early syphilis.MethodsSyphilis patients visited the Dermatological Department of Beijing Tongren Hospital, Capital Medical University from January 2012 to October 2016 were recruited, including 189 patients with early syphilis and 39 patients without clinical symptoms but with risky behavior within 3 months. Serum samples were tested by TPPA and TRUST respectively before treatment and at month 3, 6, 12 after treatment. Comparison between groups was done by χ^2 test.ResultsSerum TPPA results of 228 patients with early syphilis prior to the treatment and within 12 months after treatment were all positive. Before treatment, TRUST tests results of 225 patients were positive, and 156 patients turned negative after 12 months of treatment with the negative conversion rate of 69.3%. The TRUST titer ≤1∶4 before treatment was defined as low-titer group, and ≥1∶8 before treatment was defined as high-titer group. There were 93 patients in the low-titer group, including 3 patients with negative results, and 90 patients with titer 1∶1—1∶4. There were 135 patients in the high-titer group. Twenty-seven patients achieved TRUST negative conversion after 3 months of treatment, among which 19.35%（18/93） with the negative conversion rate in the low-titer group and 6.67%（9/135） in the high-titer group. The difference between the two groups was statistically significant （χ^2=7.10, P〈0.01）. Sixty-two patients converted into negative results of TRUST assay after 6 months of treatment, including 36.56%（34/93） in the low-titer group and 11.85%（16/135） in the high-titer group whose titer of 1∶1—1∶4, and 6.45%（6/93） in the low-titer group and 4.44%（6/135） in the high-titer group whose titer ≥1∶8 turned negative. The difference between the two groups was statistically significant （χ^2=17.10, P〈0.01）. There

关 键 词：血清学 早期梅毒 TRUST 滴度 治疗 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]