梅毒螺旋体特异性抗体对梅毒早期诊断和治疗的评价

目的：为评价梅毒血清特异性抗体在梅毒早期诊断及治疗后的意义。方法：采用蛋白印迹法(Western blottinG，WB)、快速血浆反应素(RPR)试验、梅毒颗粒凝集试验(TPPA)3种方法．对67例梅毒及其中经治疗后随诊18～24个月的21例患者作血清检测。对5年来诊治的临床一期、二期梅毒血清抗体的变化进行分析。结果：20例一期梅毒WB检测出现不同抗体谱条带，其中均有相对分子质量为47000的条带，RPR试验及TPPA部分为阴性。经治疗后随诊18-24个月的21例梅毒患者．18个月内检测时WB9．52％阴转，24个月时28．57％阴转；TPPA阴转的情况同WB；RPR滴度随疗后时间的增加而逐渐下降．6个月内28．57％阴转，24个月85．71％阴转：结论：相对分子质量为47000、17000的条带对早期梅毒的诊断既敏感又特异：部分一期和二期梅毒患者在经过有效治疗后2年，梅毒抗体可以完全消失；RPR试验可用于梅毒治疗期间的疗效判定。

Evaluation of specific anti-47 kDa Treponema pallidum antibody for the early diagnosis and treatment of syphilis

Objective: To evaluate anti-47 kDa Treponema pallidum antibody for the early diagnosis and treatment of syphilis, we analyzed the levels of serologic antibodies in the primary and secondary syphilis in the last five years. Methods: By using Western blotting (WB), RPR test and TPPA, serologic antibodies were detected in 67 cases of syphilis, of whom 21 were followed up for 18 to 24 months after treatment. Results: In 20 patients with primary syphilis, different antibody bands were detected by WB, however, they all showed antibody to 47 kDa antigen, but some of the sera were negative for RPR test and TPPA. Eighteen to 24 months after treatment, 21 patients were repeatedly examined by WB, the antibody to 47 kDa antigen turned to negative after 18 months in 9.52% of the patients, and 28.57% after 24 months. The same negative changes of TPPA as WB were observed. The titers of RPR tests decreased along with the duration after treatment, the negative rates were 28.57% after 6 months and 85.71% after 24 months, respectively. Conclusions: The antibody to 47 kDa antigen was sensitive and specific to the diagnosis of primary syphilis. Twenty-four months after treatment, the specific antibody in some patients could become negative. The titer of RPR test is a useful serologic index for the observation of therapeutic effects.