不同方法检测非先天性梅毒患儿体内梅毒抗体衰减规律的应用评价  

Evaluation of different detection methods for decline pattern of syphilis antibody in non-congenital syphilis children

作　　者：徐敬轩[1] 彭文红[1] 王佳丽[1] 钱云芳[1] 赵仙华 冷柠 杨勇[1] 储磊[2] 谢而付 XU Jingxuan;PENG Wenhong;WANG Jiali;QIAN Yunfang;ZHAO Xianhua;LENG Ning;YANG Yong;CHU Lei;XIE Erfu(Department of Laboratory Medicine,the Second Hospital of Danyang,Danyang 212300,Jiangsu;Department of Laboratory Medicine,Danyang People's Hospital,Danyang 212300,Jiangsu;Department of Laboratory Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]丹阳市第二人民医院检验科,江苏丹阳212300 [2]丹阳市人民医院检验科,江苏丹阳212300 [3]南京医科大学第一附属医院检验学部,南京210029

出　　处：《临床检验杂志》2025年第2期88-91,共4页Chinese Journal of Clinical Laboratory Science

基　　金：丹阳市重点研发计划(社会发展)(SSF202113)。

摘　　要：目的探讨不同检测方法在监测非先天性梅毒患儿体内梅毒特异性抗体衰减规律中的应用价值。方法纳入80例非先天性梅毒患儿,采集出生后血清标本,分别用电化学发光法(ECLIA)、免疫印迹法(WB)、梅毒螺旋体颗粒凝集试验(TPPA)、酶联免疫吸附试验(ELISA)和甲苯胺红不加热血清试验(TRUST)检测梅毒特异性抗体。每3个月随访1次,直至ELISA和TRUST结果转阴。结果ECLIA法显示,非先天性梅毒患儿体内梅毒特异性抗体水平在出生后2~3个月内可降至出生时的25%,且衰减速度与初始浓度无关。WB法提示,非先天性梅毒患儿出生时的特异性IgG条带与母体一致,其消退顺序依次为TPN47、TPN15、TPN45和TPN17。受方法学限制,ELISA法在高浓度抗体存在时,出生后前3个月吸光度变化不明显,但对低浓度抗体的检出灵敏度高。以ELISA阳性为参考,比较ECLI、TPPA和WB方法的检出率:出生时分别为100%、100%和90%,3月龄时为100%、100%和75%,6月龄时为100%、46%和15%,9月龄时为83%、33%和0%。TRUST阳性率在出生时为17.5%,3月龄随访时均转阴。结论梅毒特异性IgG抗体可完全传递给胎儿,并在出生后按一定规律消退。综合分析4种方法的检测结果,ECLIA法动态检测可在随访3个月时提前判断非先天性梅毒风险或终止随访,WB法早于TPPA法提示阴转,而ELISA法需随访时间最长。ObjectiveTo explore the application values of different detection methods in monitoring the decline pattern of syphilis-specific antibody in the non-congenital syphilis children.Methods A total of 80 non-congenital syphilis children were included in the study.The serum specimens were collected after birth,and the syphilis-specific antibodies were detected using electrochemiluminescence immunoassay(ECLIA),western blotting(WB),treponema pallidum particle agglutination assay(TPPA),enzyme-linked immunosorbent assay(ELISA),and toluidine red unheated serum test(TRUST).Follow-up was conducted every three months until the positive results of ELISA and TRUST turned to negative.Results The results of ECLIA showed that the syphilis-specific antibody levels in the non-congenital syphilis children declined to 25%of the level at birth within 2 to 3 months,and the rate of decline was independent of the initial concentration.WB analysis indicated that the specific IgG bands in non-congenital syphilis children at birth were consistent with those of their mother,and the sequence of specific antibodies decline was as follows:TPN47,TPN15,TPN45,and TPN17.Due to methodological limitations,the absorbance values of ELISA showed no significant change during the first three months after birth when high concentrations of antibodies were present in the samples,but it showed high sensitivity in the detection for the samples with low-concentration of syphilis antibodies.The detection rates of ECLIA,TPPA,and WB were compared by using ELISA as the reference method.At birth,the detection rates of syphilis antibodies were 100%,100%,and 90%,respectively.In 3 months after birth,the detection rates were 100%,100%,and 75%.In 6 months after birth,,they were 100%,46%,and 15%.In 9 months after birth,they were 83%,33%,and 0%.The positive rate of TRUST was 17.5%at birth.and turned to negative in 3 month of follow-up.Conclusion Syphilis specific IgG antibodies may fully transferred to the fetus and decline in a predictable pattern after birth.The comprehen

关 键 词：妊娠梅毒 甲苯胺红不加热血清试验 酶联免疫吸附试验 电化学发光法 免疫印迹法 

分 类 号：R446[医药卫生—诊断学]