早期梅毒51例临床与实验分析

目的：分析早期梅毒的临床特点，评价梅毒实验室诊断技术。方法：总结５１例早期梅毒的临床表现，对ＲＰＲ、ＦＴＡ－ＡＢＳ、蛋白印迹法以及ＰＣＲ等多种诊断方法进行评价。结果：一期梅毒较少，多表现为不典型下疳，女性患者易于漏诊；二期梅毒较多，临床表现多我样但皮疹常以阴剖为主，掌跖暗红色斑疹、肛周扁平湿疣较为常见。在实验诊断方面，ＲＰＲ对本组病例的敏感性为７３．２％，ＦＴＡ－ＡＢＳ为９４．１％，蛋白印迹法为１

Clinical analysis and laboratory evaluation on 51 cases of early syphilis

Objective:Analyze clinical manifestation of early syphilis and evaluate the laboratory techniques of diagnosis. Methods:51 cases of early syphilis were summarized, RPR, FTA ABS, Western blot and PCR techniques were compared in the diagnosis. Results:Primary syphilis, 6 of 51 cases (11.8%), often appear an atypical chancres or irregular ulcers at genital organ, which may be easily lost from early diagnosis in female patients. Most of the patients reported in this paper were grouped as secondary syphilis (74.5%), the clinical characteristic lesions of which, important for differential diagnosis, are multiform syphilides concentrated around genital area, dark red macules at palm and sole sites, and perianus condyloma flat. Several laboratory techniques were evaluated in the diagnosis of those patients. RPP as a screening method showed a low sensitivity (73.2%), FTA ABS as a confirmation test is widely used at present, high quality of the antigen smear is the crucial point of a success experiment. Western blot and PCR techniques are highly sensitive methods but still under researching and developing, more clinical data should be accumulated to testify the efficiency of the techniques. Conclusion:secondary syphilis is the major clinical type at present; specific test to the antigen of treponema padium such as FTA ABS is the first choice in the laboratory diagnosis of syphilis.