特异性IgG抗体亲和指数在人梅毒原发感染中的诊断价值  

Diagnostic Value of Specific Ig G Antibody Affinity Index in Primary Human Syphilis Infection

作　　者：李建春[1] LI Jianchun(The First Affiliated Hospital of Nanchang University,Nanchang City,Jiangxi Province 330006)

机构地区：[1]南昌大学第一附属医院,江西省南昌市330006

出　　处：《医学理论与实践》2023年第4期559-561,555,共4页The Journal of Medical Theory and Practice

基　　金：江西省卫健委科技计划(2013029)。

摘　　要：目的:探讨梅毒螺旋体特异性IgG抗体(Tp-IgG)亲和指数(AI)在人梅毒原发感染诊断中应用的可行性。方法:选取2019年4月—2021年4月间我院收治的梅毒螺旋体感染患者87例作为实验对象,采用间接ELISA法对Tp-IgG、Tp-IgM抗体进行检测,依据测定结果进行分组:既往感染组(A组)、继发/再感染组(B组)、原发感染组(C组),分别检测各组患者Tp-IgG AI差异。结果:87例梅毒螺旋体感染患者经TP-IgG及TP-IgM检测结果显示,既往感染组(A组)52例(59.77%),继发/再发感染组(B组)14例(16.09%),原发感染组(C组)21例(24.14%);以TP-IgG与TP-IgM检测结果将患者分为原发感染组(21例)及非原发感染组(66例),分析显示当TP-IgG AI判断标准在>35%且<40%时Youden指数最高(0.732)。非原发感染组患者AI值为(68.52±14.11),显著高于原发感染组的(40.36±13.05)(t=8.105,P<0.05);非原发感染组患者AI值多分布在45%~50%,而原发感染组多集中在<35%。结论:TP-IgG AI判断标准在35%~40%时对原发人梅毒螺旋体感染诊断的敏感度、特异度较高,能够作为鉴别原发性梅毒感染的诊断措施。Objective: To investigate the feasibility of the application of Treponema pallidum specific IgG antibody(Tp-IgG) affinity index(AI) in the diagnosis of human syphilis primary infection.Methods:A total of 87 patients with Treponema pallidum infection admitted to our hospital from April 2019 to April 2021 were selected as the experimental subjects. Tp-IgG and Tp-IgM antibodies were detected by indirect ELISA method, and grouped according to the test results: Previous infection group(group A), secondary/reinfection group(group B), and primary infection group(group C),the differences in Tp-IgG AI of patients in each group were detected respectively. Results:The TP-IgG and TP-IgM detection results of 87 patients with Treponema pallidum infection showed that there were 52 patients(59.77%) in the previous infection group(group A) and 14 patients in the secondary/recurrent infection group(group B)(16.09%),21 cases in the primary infection group(group C)(24.14%);the patients were divided into the primary infection group(21 cases) and the non-primary infection group(66 cases) according to the detection results of TP-IgG and TP-IgM,the analysis showed that the Youden index was the highest(0.732) when the TP-IgG AI criteria were >35% and <40%.The AI value of patients in the non-primary infection group was(68.52±14.11), which was significantly higher than that in the primary infection group(40.36±13.05)(t=8.105,P<0.05);the AI value of the patients in the non-primary infection group was mostly distributed in 45%~50%,while the primary infection group was mostly concentrated in <35%. Conclusion:The TP-IgG AI judgment standard has high sensitivity and specificity for the diagnosis of primary human Treponema pallidum infection when the criterion is 35%~40%, and can be used as a diagnostic measure to identify primary syphilis infection.

关 键 词：梅毒 梅毒螺旋体抗体 特异性IGG抗体 原发性感染 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]