353例梅毒患者脑脊液、血清检测结果及神经梅毒预测分析  

An Analysis of Cerebrospinal Fluid and Serological Results on Patients with SyphiIis and Their Predictive Values for Neurosyphilis

作　　者：李韦杰 郭杰[1] 迟小伟[2] 周淳[1] 郭晶晶[1] 曲沛[1] 马小艳[1] 刘颖[1] 徐新民[1] 金方方 张书凤[1] 王雅杰 LI Weijie;GUO Jie;CHI Xiaowei;ZHOU Chun;GUO Jingjing;QU Pei;MA Xiaoyan;LIU Ying;XU Xinmin;JIN Fangfang;ZHANG Shufeng;WANG Yajie(Department of Clinical Laboratory, Beijing Ditan hospital, Capital Medical University, Beijing 100015, China;Department of Clinical Laboratory,The Affiliated Hospital of Shandong University of Traditional Chinese Medicin,Jinan 250012,China)

机构地区：[1]首都医科大学附属北京地坛医院检验科,北京100015 [2]山东中医药大学附属医院检验科,山东济南250012

出　　处：《标记免疫分析与临床》2020年第5期724-728,733,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的分析梅毒患者脑脊液和血清的实验室检查结果,探讨神经梅毒的血清学预测因子。方法回顾性分析本院2015年1月至2019年12月收治的梅毒患者共353例,其中普通梅毒患者181例,神经梅毒患者172例。比较两组患者脑脊液常规、生化,脑脊液和血清(同一时间收集)荧光梅毒螺旋体抗体吸附试验IgG(FTA-ABS-IgG)、荧光梅毒螺旋体抗体吸附试验IgM(FTA-ABS-IgM)、梅毒螺旋体明胶颗粒凝集试验(TPPA)、甲苯胺红不加热血清试验(TRUST)及外周血T、B、NK淋巴细胞分型检测结果。结果神经梅毒组患者和普通梅毒组患者在年龄、性别、血清TRUST滴度、CSF TRUST阳性率、CSF TPPA阳性率、CSF FTA-ABS-IgG阳性率方面存在差异,具有统计学意义(P均<0.01)。患者血清TRUST滴度与患神经梅毒可能性呈正相关(r=0.234,P<0.001),ROC显示其曲线下面积为0.633,截点值为1∶8稀释浓度,特异性为83.43%。当滴度为1∶64时,特异性为98%。结论神经梅毒患者较普通梅毒患者年龄大,男性为主。血清TRUST滴度越高,患神经梅毒的可能越大。Objective To investigate the predictive values of cerebrospinal fluid and serological results on neurosyphilis in patients with syphilis.Methods A total of 353 syphilis patients who underwent lumbar puncture from January,2015 to December,2019 were enrolled into this study,including 172 patients with neurosyphilis and 181 patients with non-neurosyphilis.Data of TRUST,TPPA,FTA-ABS-IgG,and FTA-ABS-IgM from cerebrospinal fluids(CSF)and serum,as well as results of routine and biochemical analysis of CSF,lymphocyte typing in peripheral blood were retrospectively analyzed.Results The levels of age,serum TRUST titer,positive rate of TRUST,CSF TPPA,and CSF FTA-ABS-IgG in the neurosyphilis group were significantly higher than those in the non-neurosyphilis group(P<0.01).The higher serum TRUST titer was,the more chance of developing neurosyphilis(r=0.234,P<0.001).The area under the ROC curve of serum TRUST was 0.663 at the cut-off value of 1∶8 dilution,and the specificity was 83.43%.When the dilution was 1∶64,the specificity was 98%.Conclusion The higher the serum TRUST titer is,the greater chance of neurosyphilis can be.

关 键 词：神经梅毒 CSF 梅毒螺旋体明胶颗粒凝集试验 甲苯胺红不加热血清试验 荧光梅毒螺旋体抗体吸附试验 

分 类 号：R377.1[医药卫生—病原生物学]