先天梅毒实验室诊断方法学研究

摘要

目的 研究先天梅毒实验室检测实用性、特异性的方法,应用于新生儿梅毒的早期诊断.方法 应用国内外最新的梅毒检测技术,以梅毒螺旋体明胶颗粒凝集试验(TPPA)与甲苯胺红不加热血清试验 (TRUST)作为基础实验,辅以其它特异性诊断实验,达到快速、准确、特异的诊断目的.结果 2010~2014年全院共检测门诊及住院患者66 338例,其中,产科住院孕产妇30 225例,产科门诊孕产妇10 250例,针对性检测临床疑似新生儿梅毒感染患儿189例,其中住院孕产妇双阳性率(TPPA、TRUST均阳性)0.36%,产科门诊孕产妇双阳性率0.63%,疑似新生儿梅毒感染患儿阳性率19.58%.检出新生儿梅毒患儿11例,约占住院孕产妇0.36‰.结论 使用逆向操作法应用于常规梅毒组合检测,采用蛋白印迹技术针对性检测,提高了孕产妇及新生儿梅毒检测的特异性,应用于新生儿胎传梅毒的早期诊断可为临床诊断先天梅毒提供依据.%Objective Practical and specificity of laboratory testing on congenial syphilis are to be researched in order to apply it to diagnose early-stage congenial syphilis in new-born babies.Methods Application of abroad latest laboratory testing technique based on TPPA and TRUST, and supplemented other specific laboratory tests in order to make the rapid,accurate and specified diagnosis.Results There are totaly 66 338 patients treated clinicaly and hospitalized from 2010 to 2014,including 30 223 cases of hospitalized pregnant patients,10 250 cases of clinicaly treated pregnant patients and 189 cases of clinicaly suspected congenial syphilis new-born babies. TPPA and TRUST of hospitalized pregnant patients were up to 0.36%,while,TPPA and TRUST of clinicaly treated pregnant patients were up to 0.63%. And the positive rate of suspected newborn babies infected with congenital syphilis was 19.58%,there are 11 newborn babies diagnosed as congenital syphilis,accounting for 0.36‰ of pregnant patients in total.Conclusion Application of reverse operation to test routine syphilis and application of western blotting to test specific syphilis are conducive to increasing specificity of syphilis test for pregnant women as wel as newborn babies,and what's more,the early-stage diagnosis of newborn babies could provide basis for clinical diagnosis of congenital syphilis.