蛋白免疫印迹和荧光-PCR诊断早期先天梅毒研究

目的评价荧光定量聚合酶链反应（FQ-PCR）和血清IgM抗体蛋白免疫印迹实验（serum IgM western blot,IgM-WB）在新生儿先天梅毒早期诊断中的作用. 方法在知情同意的情况下,选取34例梅毒孕妇及其新生儿和40例非梅毒对照孕妇及其新生儿,分别给予荧光定量聚合酶链反应、血清IgM-WB试验和常规血清学方法（TPPA、RPR、19S-FTA-ABS）,以双盲对照的形式评价上述实验诊断方法和常规实验室检测（临床＋常规血清学方法RPR滴度的比较＋治疗）在先天梅毒早期诊断的作用. 结果 34例孕妇梅毒病例所生的新生儿中,按常规综合诊断方法3例确诊为先天梅毒,6例拟诊为先天梅毒.34例完成妊娠的梅毒孕产妇病例中,孕妇胎盘和脐带组织荧光定量聚合酶链反应11例阳性（9例常规方法诊断为先天梅毒）;新生儿血清IgM蛋白印迹试验10例阳性（9例常规方法诊断为先天梅毒）;40例作为对照的非梅毒孕妇及新生儿各项检查均为阴性. 结论胎盘组织荧光定量聚合酶链反应和血清IgM蛋白印迹试验诊断梅毒,结果显示可能高于现行的常规综合诊断方法的诊断价值,且优于常规综合诊断方法中的任何一种.

The value of FQ-PCR and Western blot in early diagnosis of congenital syphilis

Objective To evaluate the effects of FQ-PCR and Western blotting (WB) in detection of placental Treponema pallidum DNA for diagnosis of congenital syphilis. Methods Thirty-four placental specimens from pregnant women with syphilis and forty specimens from health pregnant women were evaluated by using double blind methods: (1)FQ-PCR and WB for placental Treponema pallidum DNA;(2)Traditional comprehensive approach for the diagnosis of congenital syphilis. The results were compared. Results Positive FQ-PCR (9 congenital syphilis) was observed in 11 out of the 34 placental specimens from syphilitic women, 10 positive serum IgM was detected by Western blot (9 congenital syphilis). No positive results were observed in the 40 infants from health mothers. Conclusion The diagnostic value of FQ-PCR and Western blot in detection of placental Treponema pallidum DNA and serum IgM is superior to any one of the conventional methods.