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目的探讨脑脊液实时荧光定量PCR对于神经梅毒的诊断价值。方法对大连市皮肤病医院2011年1月-2016年1月155例疑似神经梅毒患者的临床资料及脑脊液等进行综合分析,同时用实时荧光定量PCR、TP-ELISA、VDRL法检测所有待测者脑脊液;比较分析检测结果的敏感度与特异度。结果共诊断31例神经梅毒患者(1例待观察最终确诊),TP-ELISA检测神经梅毒的敏感度与特异度分别为96.88%和38.71%,实时荧光定量PCR检测神经梅毒的敏感度与特异度分别为64.52%和100.00%,VDRL检测神经梅毒的敏感度与特异度分别为93.55%和100.00%。结论脑脊液实时荧光定量PCR虽然具有高敏感度、高特异度等优点,但对脑脊液标本要求较高,是否可作为神经梅毒的临床诊断标准有待进一步研究。
Objective To investigate the diagnostic value of cerebrospinal fluid real-time fluorescence quantitative PCR for neurosyphilis. Methods A total of 155 patients with suspected neurosyphilis in Dalian Dermatology Hospital from January 2011 to January 2016 were enrolled in this study. The clinical data and cerebrospinal fluid were analyzed comprehensively. All the subjects were tested by real-time fluorescence quantitative PCR, TP-ELISA and VDRL Cerebrospinal fluid; comparative analysis of test results sensitivity and specificity. Results A total of 31 patients with neurosyphilis were diagnosed. One case was diagnosed finally. The sensitivity and specificity of TP-ELISA in detecting neurosyphilis were 96.88% and 38.71% respectively. The sensitivity and specificity of real-time fluorescence quantitative PCR Respectively 64.52% and 100.00%. The sensitivity and specificity of VDRL in detecting neurosyphilis were 93.55% and 100.00% respectively. Conclusion Although real-time PCR of cerebrospinal fluid (CSF) has the advantages of high sensitivity and high specificity, it has higher requirements on cerebrospinal fluid samples. Whether it can be used as a clinical diagnostic criteria of neurosyphilis remains to be further studied.