疑似梅毒患者血液47KDa和15KDa膜免疫原基因的测定

目的研究巢式聚合酶链反应(PCR)在排除梅毒血清学试验假阳性中的作用。方法用巢式PCR和常规PCR扩增90例疑似梅毒患者全血中梅毒螺旋体(TP)的47KDa和15KDa的膜免疫原基因,并与血清学方法(RPR,TPPA)的检验结果作比较。结果巢式PCR检测TP的敏感性和特异性分别为93.33%和96.67%,两者符合率为96.67%;两种PCR方法检测结果差异有统计学意义(P<0.01),巢式PCR敏感性高于常规PCR。结论巢式PCR检测全血中TP较常规PCR灵敏,通过检测47KDa和15KDa的膜免疫原基因,有助于排除梅毒血清学试验假阳性,提高了梅毒诊断的准确率。

Detection of the 47-kilodalton and the 15-kilodalton Membrane Immunogen Gene of Treponema Pallidum in Whole Blood of Suspected Patients with Syphilis

Objective To investigate the contribution of a nested polymerase chain reaction(PCR)assay to eliminate serological false positive test for syphilis.Methods Routine PCR and nested PCR assays were performed to amplify specific fragments of the 47-kilodalton and the 15-kilodalton membrane immunogen gene of treponema pallidum from 90 whole blood samples of patients with suspected syphilis.At the same time,we compared the results of the nested PCR with serological tests.Results By directly comparing with serology,nested PCR showed 96.67% agreement,with a sensitivity of 93.33% and a specificity of 96.67%.There were significant differences between the two PCR assays in detection of TP from whole blood and the nested PCR was sensitive than the routine PCR(P<0.01).Conclusion The nested PCR assay is more sensitive than the routine PCR assay in detecting low numbers of TP in whole blood samples,which can eliminate serological false positive test for syphilis and improve the accuracy rate of diagnosis.