梅毒螺旋体IgM抗体在梅毒血清固定中的应用

目的：探讨梅毒螺旋体特异性IgM（TP—IgM）抗体在梅毒血清固定中的应用。方法：对285例梅毒患者中病程1年以上,快速血浆反应素环状卡片试验（RPR）阳性且血清固定患者,用免疫印迹法检测TP—IgM抗体。结果：285例梅毒患者中,28例发生血清固定,经TP—IgM检测,阳性8例,阴性20例;28例血清固定患者中,17例二期梅毒患者TP—IgM抗体阳性5例,阴性12例;11例潜伏梅毒患者中TP—IgM抗体阳性3例,阴性8例;无一期梅毒。结论：梅毒螺旋体特异性IgM抗体可作为梅毒血清固定患者感染并活动的一项血清学指标。     

Seropositivity of the rapid plasma reagin (RPR) test in a dental school patient population: a retrospective study

OBJECTIVES: The purpose of this retrospective study was to determine the seropositivity of the rapid plasma reagin (RPR) in a dental school patient population. METHODS: Blood was drawn on 20,844 subjects registering for treatment at the Louisiana State University School of Dentistry. All subjects who are admitted to the dental school are submitted to RPR screening (Macro-Vue-RPR Card, Becton Dickinson), blood indices, and serum chemistries. Venereal Disease Research Laboratory (VDRL), microhemagglutination assay for Treponema pallidum (MHA-TP) and/or fluorescent treponemal absorption test for Treponema pallidum (FTA-ABS) were also run on the positive RPR results. RESULTS: Two hundred seventy-nine (1.34%) of the 20,844 were RPR-positive. Sixty-two subjects (0.30%) of this total population from the RPR-positive findings were nonreactive (biological false positives or BFP) to the MHA-TP and FTA-ABS. This left 217 (1.04%) subjects of the 20,844 screened who were seropositive on both the RPR and the FTA-ABS or MHA-TP. CONCLUSIONS: Since this study has not been performed in a dental school patient population setting, comparison with other institutions is difficult. The authors agree that routine RPR testing is helpful and cost effective to detect patients possibly infected with Treponema pallidum in a large patient population.     

两种检测梅毒螺旋体抗体方法的比较

目的:比较ELISA TP-IgG和快速血浆反应素试验(rap id p lasm a reagin c irc le card test,RPR)梅毒检测试剂的敏感性和特异性。方法:采用ELISA TP-IgG和RPR 2种试剂同时对56份临床疑似标本进行检测,结果阳性者采用梅毒螺旋体特异性抗体乳胶凝集试验(Toreponem a pallidum latex immuno assay,TPLA)方法进行验证。结果:ELISA TP-IgG检测率高于RPR,且与TPLA确证实验完全吻合。结论:ELISA TP方法在敏感性和特异性方面均好于RPR方法,是临床检测梅毒感染和筛选献血员的首选方法。     

实验室常用梅毒检测方法的评价

梅毒是一种经典的通过性和母婴传播的疾病，其传染性强，感染后可以引起全身各组织、器官的损害，危害较大。近年来，梅毒的发病率呈上升趋势。在梅毒诊断中，由于抗体效价或方法特异性等原因使诊断结果常出现偏差，因此，高效的梅毒实验室诊断已成为大势所趋，对控制梅毒蔓延意义重大。临床实验室合理、有效地选用检测方法，避免错诊、误诊、漏诊是非常必要的。     

Effects of lesions of various brain areas on drug priming or footshock-induced reactivation of extinguished conditioned place preference

The effect of Radix paeoniae rubra (RPR) on voltage-gated sodium channel (VGSC) currents (I_Na) was examined in freshly isolated rat hippocampal CA1 neurons using whole-cell patch-clamp technique under voltage-clamp conditions. RPR suppressed I_Na without affecting the current activation, inactivation and deactivation. The amplitude of I_Na decreased by 18.4% within a few seconds of 0.8 mg/ml RPR exposure. RPR (0.8 mg/ml) shifted the steady-state inactivation curves of I_Na to negative potentials, with hyperpolarizing direction shift of V_1/2 of 10.0 mV. The time course of I_Na recovery from inactivation was prolonged significantly by 0.8 mg/ml RPR. RPR (0.8 mg/ml) also enhanced the activity-dependent attenuation of I_Na and decreased the fraction of activated channels. These results suggested that RPR suppressed hippocampal CA1 I_Na by shifting the inactivation curve in hyperpolarizing direction, slowing the recovery time course from inactivation, enhancing the activity-dependent attenuation and decreasing the number of activatable channels. RPR suppression on I_Na might predict the protective effect during brain ischemia in hippocampal CA1 neurons.     

妊娠期梅毒治疗药物对妊娠结局和新生儿预后的影响研究

目的 通过比较苄星青霉素与头孢曲松治疗妊娠期梅毒的效果,观察其妊娠结局及新生儿预后比较,为治疗妊娠期梅毒提供更佳治疗方案.方法 将孕早期及中期确诊妊娠期梅毒患者187例,随机分为试验组85例和对照组102例,孕妇年龄、文化程度、胎次、丈夫感染情况以及RPR滴度无差异,试验组给予头孢曲松1.0 g,1次/d,肌内注射,共10 d治疗,对照组给予苄星青霉素240万U,分两部分给予臀部肌内注射,每周1次,连续3周为1个疗程治疗,孕晚期重复治疗1个疗程.从足月、早产及死胎、死产及新生儿窒息情况观察2组妊娠结局;从新生儿出生后RPR滴度了解新生儿预后;随访其3个月、6个月、12个月、18个月变化,了解其梅毒抗体转阴情况.结果 2组在妊娠结局如早产、死胎及新生儿窒息发生率上差异无统计学意义(P>0.05),婴儿梅毒抗体转阴上差异无统计学意义(P>0.05),经积极治疗后无死胎发生.结论 头孢曲松钠和青霉素具有对妊娠梅毒同样的治疗效果.     

应用双抗原夹心ELISA法筛查献血员梅毒螺旋体抗体

目的：优选一种适宜于献血员梅毒筛查的试验方法。方法：采用检测梅毒特异性抗体的双抗原夹心ELISA法对献血员进行抗体检测，并与RPR检测结果进行比较，对两种方法检测结果不一致的标本，再用TPHA法进行确证。结果：ELISA法阳性检出率0．36％(41／1271)、RPR法阳性检出率0．26％(29／11271)。ELISA法与TPHA法总符合率97．5％(40／41)、RPR法与TPHA总符合率63．41％(26／41)。结论：ELISA法优于RPR法，具有较高的灵敏度和特异性，适宜于献血员的筛查．有利于控制和减少梅毒的输血传播。     

抗梅毒螺旋体主要抗体与RPR的关系探讨

目的 分析梅毒阳性血清抗TP15、17、47单组分抗体的检出情况并探讨其与梅毒心磷脂反应素的关系.方法 分别建立抗TP15、17、47 ELISA双抗体夹心法检测梅毒阳性血清,再用苍白密螺旋体颗粒(明胶)凝集试验(TPPA)法确定,同时快速血浆反应素试验(RPR)法测定抗心磷脂反应索阳性滴定度.结果 抗TP15、17、47与常规ELISA的阳性不符合率分别为15.2%,3.3%和5.1%,各组分抗体强度的分布不同;ELISA检测的OD值与TPPA检测时血清的抗体强度无相关性(r=0.073);比较3种抗TP单组分抗体的OD值在RPR阳性和阴性组的差异均有统计学意义.结论 抗TP15、17、47单组分抗体与ELISA有不同的阳性不符合率,ELISA与TPPA检测的血清抗体强度无相关性;RPR的阳性检出率为47.1%,3种抗TP单组分抗体均为阳性而RPR阳性组OD值低于阴性组.     

梅毒螺旋体检测方法的临床评价

目的 探讨三种血清梅毒螺旋体检测方法的应用价值.方法 应用快速血浆反应素试验(RPR)、酶联免疫吸附试验(ELISA)、梅毒螺旋体明胶凝集试验(TPPA)分别检测602份标本,其中61例确诊为梅毒感染.荧光定量PCR(FQ-PCR)方法对RPR阳性标本进行检测.结果 ELISA法与TPPA法检测结果之间无显著性差异(P＞0.05),二者敏感性和特异性分别为95.1%、97.8%和91.8%、96.9%;RPR与ELISA法、TPPA法之间有显著性差异(P＜0.05);FQ-PCR法检测结果均为阴性.结论 ELISA法和TPPA法是较好的血清梅毒螺旋体的检测方法.FQ-PCR法检测的阳性率低.