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目的探讨免疫印迹实验检测潜伏梅毒孕妇及其新生儿血清梅毒螺旋体IgM蛋白情况及其临床随访意义。方法对54例潜伏梅毒孕妇及其所生新生儿分别进行甲苯胺红不加热血清反应素试验(TRUST)、梅毒螺旋体血球凝集试验(TPHA)和梅毒螺旋体IgM蛋白免疫印迹实验(TP-IgM-WB),追踪梅毒孕妇及其新生儿梅毒感染情况。结果孕期治疗对孕妇TRUST阴转率并无影响。TP-IgM-WB经治疗后阴转率比治疗前明显提高(P<0.05),其中孕早期治疗后阴转率为35.19%,孕晚期治疗后全部阴转。TRUST低滴度(≤1:8)组TP-IgM平均阴转时间为(2.54±1.21)月,高滴度(≥1:16)组为(3.68±1.96)月,前者明显比后者短(t=5.94,P<0.01)。所生新生儿均为足月活胎,未发现先天梅毒患儿。且TRUST滴度均低于或等于母亲分娩前滴度。结论潜伏梅毒孕妇经规范驱梅治疗后能有效阻断胎传梅毒。检测抗梅毒螺旋体IgM抗体可初步推断潜伏梅毒孕妇的病程并判断其传染性,规范驱梅治疗后能快速阴转,有助于潜伏梅毒孕妇及其新生儿血清学随访。
Objective To investigate the clinical significance of detecting serum IgM protein of Treponema pallidum in pregnant women with latent syphilis and their newborns by Western blotting. Methods Totally 54 pregnant women with latent syphilis and their newborn infants were subjected to TRUST, TPHA and TPM immunoblotting (TP-IgM-WB ), Tracking syphilis pregnant women and their newborns syphilis infection. Results Pregnancy treatment had no effect on TRUST negative conversion rate in pregnant women. After treatment, the negative conversion rate of TP-IgM-WB was significantly higher than that before treatment (P <0.05). The negative conversion rate of TP-IgM-WB was 35.19% after the first trimester of pregnancy. The average time of negative TP-IgM in TRUST low titers (≤1: 8) was (2.54 ± 1.21) months and that in high titers (≥1: 16) was (3.68 ± 1.96) months, the former was significantly shorter than the latter (t = 5.94, P <0.01). The newborn infants are full-term live births, no congenital syphilis was found in children. TRUST titers were lower than or equal to the mother before delivery titers. Conclusions Latent syphilis pregnant women can effectively block the syphilis of fetus after standardized treatment of plum. Detection of anti-Treponema pallidum IgM antibodies can initially infer the course of latent syphilis in pregnant women and determine its infectivity, normative drive Mei quickly after treatment, contribute to the latent syphilis in pregnant women and their newborns serological follow-up.