免疫印迹法检测梅毒患者血清中IgG抗体临床意义及方法学评价

目的 探讨免疫印迹法检测梅毒感染患者血清中IgG抗体检测的临床意义。方法 采用免疫印迹法对临床确诊为梅毒的患者血清标本59 、正常献血员血清标本25例及生物性假阳性标本20例等进行了检测，并与梅毒特异性抗体检测的标准方法荧光梅毒螺旋体抗体吸附实验（FTA－ABS）、酶联免疫吸附实验（ELISA）和梅毒螺旋体被动明胶颗粒凝集实验（TPPA）结果相比较。结果 44例未经治疗的梅毒患者和15例经过治疗后的梅毒患者血清梅毒特异性抗体均为阳性，正常献血员和生物性假阳性患者结果均为阴性。59例梅毒患者中，除2例梅毒治疗后患者未检测出针对17KD多肽抗原抗体外，均检测出针对分子量为47KD，17KD和14KD多肽抗原抗体。针对上述3种多肽抗原抗体阳性率分别为100％，96．6％和100％。而针对90，60，33，30，25，22，45KD等多肽抗原抗体，在所有梅毒患者血清中亦检测出不同程度的阳性率。在51例非梅毒患者中，均未检测出针对47KD，17KD和14KD多肽抗原抗体，5例分别检测出一种或多种针对分子量为90，60，33，30，25，22KD和45KD等多肽抗原抗体。四种方法检测治疗前后梅毒患者结果一致性分别为100％和92．8％，四种方法检测梅毒的敏感度分别为100％，98．3％，98．3％，100％，经卡方检验，四种方法检测敏感度差异无显著性意义（P＞0．05）。免疫印迹法检测梅毒特异性抗体敏感度（100％）等于或高于其它三种同类方法，特异性（100％）与ELISA和TPPA两种方法相同，但显著高于FTA－ABS法（92．2％）。结论 免疫印迹法敏感度高，特异性好，操作简单，不需特殊仪器设备，阴阳性结果界线分明，易于判断，适应于临床广泛开展。

The Clinical Significance and Evaluation of Immunoglobulin G Western Blot Analysis in the Diagnosis of Syphilis

Objective To study the clinical significance of the immunoglobulin G Western blot analysis in the diagnosis of syphilis.Methods The IgG antibodies to treponemal pallidium in the serum of 44 untreated patients with syphilis,15 post treated patients with syphilis,25 normal donor and 20 biological false positives were detected by using three other common treponmal confirmatory tests,including fluorescent treponemal antibody absorption (FTA ABS),enzyme linked immunosorbent assay(ELISA) and treponemal pallidium passive particle agglutination assay(TPPA),as well as western blot assay.Results The specific IgG antibodies to treponemal pallidium were positive in the serum from both 44 untreated patients with syphilis and 15 post treated patients with syphilis,but none positive result was found in 25 normal donor and 20 biological false positive patients.Compared with the other three common confirmatory tests,the sensitivity of western blot assay(100%) is equal or higher than that of them,the specificity (100%) of it is the same as that of ELISA and TPPA,but it is significantly higher than that of FTA ABS.Conclusion Wester blot assay is sensitive and specific as a treponemal confirmatory test.