Serum Treponema lgM Antibody Test for Syphilis Diagnoss  

ELISA法检测梅毒患者血清中抗苍白螺旋体IgM抗体(英文)

作　　者：郑占才[1] 张荣富[2] 溪茜[3] 

机构地区：[1]北京中日友好医院皮肤科,北京100029 [2]北京中日友好医院临床医学研究所,北京100029 [3]北京中日友好医院检验科,北京100029

出　　处：《Chinese Journal of Sexually Transmitted Infections》2003年第2期28-32,68,共6页中华性传播感染杂志（英文版）

摘　　要：Objective: To evaluate the clinical utility of testingserum anti-treponema pallidum IgM antibody in thediagnosis of syphilis patients. Methods: Seventy-two cases of syphilis were testedfor specific IgM antibody with ELISA, and the resultswere compared with RPR and TPPA. Results: The sensitivity of IgM antibody was 73.3%(11/15) in primary syphilis, 88.9% (16/18) in sec-ondary syphilis, and there was no significant differ-ence between these values (x^2=1.6363, P>0.10). Thesensitivity of IgM antibody in diagnosing latent syphi-lis was only 26.1% (6/23), much lower than the detec-tion rate in symptomatic early syphilis (x^2=17.6189, P<0.005). RPR and TPPA were both 100% sensitive inlatent and early symptomatic syphilis. Two were posi-tive for IgM in the 16 cases who had received regulartreatments 2 to 24 months before enrolled. Conclusions: Specific IgM antibody detection doesnot appear superior to RPR and TPPA in diagnosingprimary syphilis. The diagnosis of latent syphilisshould mainly rely on RPR and TPPA, since there arelow titers of IgM antibody at that stage. IgM antibodytesting alone should not be recommended for monitor-ing syphilis development or treatment efficacy. Fur-ther studies should be concerned.目的评价抗苍白螺旋体IgM抗体检测对梅毒的临床意义。方法用酶联免疫吸附测定法对72例梅毒患者进行特异性IgM抗体检测,并与RPR、TPPA结果进行比较分析。结果血清抗苍白螺旋体IgM抗体在一期梅毒的阳性率为73.3%(11/15),在二期梅毒的阳性率为88.9%(16/18),二者比较无显著性差异(x^2=1.6363,P>0.10)。在潜伏梅毒,IgM抗体阳性率为26.1%(6/23),显著低于早期显性梅毒(x^2=17.6189,P<0.005)。在一期、二期和潜伏梅毒,RPR和TPPA的阳性率均为100%。入组前2-24个月己经给予正规抗梅治疗的梅毒16例,其中IgM抗体阳性2例。结论在本研究中,检测特异性IgM抗体诊断一期梅毒并下优于RPR和TPPA。IgM抗体在潜伏梅毒敏感性低,其诊断应依靠RPR和TPPA。目前不推荐单独检测抗梅毒IgM抗体来监测病情和判断疗效。抗苍白螺旋体IgM抗体的临床意义有待更深入的研究。

关 键 词：SYPHILIS IgM antibody ELISA 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]