各类型梅毒治疗前后不同标本中TP DNA的巢式实时PCR检测结果分析  

Results of TP DNA Positive Rate in Different Specimens of Various Types of Syphilis Before and After Treatment by Nested Real-time PCR

作　　者：戴向农[1] 李青青 叶兴东[1] 曹文苓[1] 张怡 谢志敏 罗标益 DAI Xiangnong;LI Qingqing;YE Xingdong;CAO Wenling;ZHANG Yi;XIE Zhimin;LUO Biaoyi(Department of Dermatology,Guangzhou Institute of Dermatology,Guangzhou 510095,China;Department of Dermatology,Institute of Dermatology,Guangzhou Medical University,Guangzhou 510182,China)

机构地区：[1]广州市皮肤病防治所皮肤科,广东广州510095 [2]广州医科大学皮肤病研究所皮肤科,广东广州510182

出　　处：《中国皮肤性病学杂志》2021年第12期1431-1436,共6页The Chinese Journal of Dermatovenereology

基　　金：广东省科技计划项目(2012B031800014);广州市科技攻关项目(201300000166);广州市医药卫生科技重大项目(2012A031001)。

摘　　要：目的分析巢式实时PCR(NR-PCR)检测成人各类型梅毒患者不同标本中密螺旋体梅毒苍白亚种(T.pallidium,TP) DNA阳性率。方法收集初复诊梅毒患者皮损组织液拭子、静脉血、血清、脑脊液(神经梅毒)标本,并用NR-PCR法检测TP DNA,比较阳性率及其差异。结果共检测492人次梅毒患者798份各类标本。TP DNA总阳性率为39.22%(313/798),且治疗前的阳性率显著高于治疗后(71.24%vs. 10.09%,P<0.01)。不分标本类型,初诊梅毒DNA阳性率介于52.08%~87.18%,一期梅毒最低,而神经梅毒最高。不分梅毒类型,初诊期组织液拭子、血清、全血阳性率分别为71.05%、66.90%、63.64%;耳垂血(仅隐性梅毒和神经梅毒)和脑脊液(仅神经梅毒)TP DNA阳性率分别为57.69%(30/52)和63.89%(46/72);二期梅毒拭子阳性率高于一期梅毒(87.50%vs. 51.85%,OR=6.5,95%CI:1.23~34.28),二期梅毒血清与其他梅毒血清相比差异均无统计学意义(P>0.05),各类型梅毒(三期除外)全血阳性率差异有统计学意义(P<0.01),神经梅毒耳垂血阳性率高于外周静脉血阳性率(P<0.01,OR=3.59,95%CI:1.95~6.60)。结论 NR-PCR检测各类型梅毒患者TP DNA阳性率有一定差异,可作为诊断梅毒的辅助手段,且耳垂末梢血采样值得推广。Objective To analyze the positive rate of TP DNA in different specimens of various adult syphilis patients by nested real-time PCR(NR-PCR).Methods Skin lesion swabs, earlobe blood or peripheral venous blood, serum, and cerebrospinal fluid were routinely collected from patients with various syphilis, TP DNA was detected with NR-PCR assay, and TP DNA positive rates in various specimens were analyzed.Results A total of 798 samples from 492 syphilis patients were collected for the TP DNA test by NR-PCR assay.The general TP DNA positive rate was 39.22%(313/798), and the positive rate of pre-treatment was significantly higher than that of post-treatment(71.24% vs.10.09%, P<0.01).Regardless of specimen types, the positive rates of primary syphilis, secondary syphilis, tertiary syphilis, latent syphilis and neurosyphilis were 52.08%, 80.70%, 38.46%, 68.75%, and 87.18%, respectively.Regardless of syphilis stages, the TP DNA positive rates in lesion swabs, serum, and whole blood before treatment were 71.05%, 66.90%, and 63.64%, respectively.The TP DNA positive rates in earlobe blood(latent syphilis and neurosyphilis only) and cerebrospinal fluid(neurosyphilis only) were 57.69%(30/52) and 63.89%(46/72), respectively.The TP DNA positive rate in swabs of secondary syphilis was higher than that of primary syphilis(87.50% vs.51.85%, OR=6.5, 95%CI:1.23~34.28).There was no significant difference observed in serum TP DNA positive rate between secondary syphilis and any other types of syphilis(P>0.05).However, a significant difference was observed for TP DNA positive rate in whole blood between different types of syphilis(except tertiary syphilis)(P<0.01).The TP DNA positive rate in peripheral earlobe blood was higher than in peripheral venous whole blood(P<0.01, OR=3.59, 95%CI:1.95~6.60).Conclusion The positive rate of TP DNA in various types of specimens from syphilis patients detected by NR-PCR is related to the type of syphilis.The earlobe blood is worthy considering for the molecular diagnosis of T.pallidum infection.

关 键 词：梅毒 实时PCR 巢式 诊断 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]