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目的探讨女性梅毒患者经规范治疗前后,血清、尿液及阴道分泌物的梅毒螺旋体脱氧核糖核酸(TPDNA)含量,观察其泌尿、生殖道感染的情况,评估其体液的间接传染性。方法选取2015年1-12月,规范治疗前后女性梅毒患者110例,用荧光定量聚合酶链反应检测其血清、尿液及阴道分泌物TP-DNA,同时进行梅毒螺旋体抗体快速血浆反应素试验(RPR)。结果梅毒女性患者不同临床分期血清、尿液、阴道分泌物阳性率差异均有统计学意义(P<0.05);女性梅毒患者经规范治疗前,其血清、尿液及阴道分泌物TP-DNA阳性率分别为36.36%、7.27%、10.91%,治疗后分别为12.73%、0.91%、1.82%,差异均有统计学意义(P<0.05);两组组内血清、尿液及阴道分泌物中的TP-DNA阳性率之间比较差异均有统计学意义(P<0.05);女性梅毒患者经规范治疗后,RPR无明显变化组血清TP-DNA阳性率为21.43%,高于治疗有效组血清TP-DNA检测阳性率(3.70%),差异有统计学意义(P<0.05);将女性梅毒患者按照血清RPR滴度分为1∶2、1∶4~1∶8和1∶16三组,比较三组血清、尿液、阴道分泌物的TP-DNA阳性率,结果各组TP-DNA阳性率差异均有统计学意义(P<0.05)。血清TP-DNA阳性率与血清RPR滴度呈正相关(r=0.710,P<0.05)。结论女性梅毒患者的血清、尿液、阴道分泌物中存在梅毒螺旋体,治疗后仍有部分血清、尿液及阴道分泌物中检出TP-DNA阳性,体液也是梅毒的间接传染源。
Objective To investigate the contents of TP DNA in serum, urine and vaginal secretions of female syphilis patients before and after the standard treatment, and to observe the urinary and reproductive tract infections, and to evaluate the indirect infectivity of the body fluids. Methods From January to December 2015, 110 female patients with syphilis were screened before and after treatment. The serum, urine and vaginal secretions of TP-DNA were detected by fluorescence quantitative polymerase chain reaction (RT-PCR), and the rapid plasma test of antibody against Treponema pallidum RPR). Results The positive rates of serum, urine and vaginal secretions in different stages of syphilis patients were significantly different (P <0.05). Before treatment of female syphilis, TP-DNA was positive in serum, urine and vaginal secretions The rates were 36.36%, 7.27% and 10.91% respectively. After treatment, they were 12.73%, 0.91% and 1.82%, respectively, with statistical significance (P <0.05). The serum, urine and vaginal secretions (P <0.05). The positive rate of TP-DNA in female patients with syphilis was 21.43%, which was significantly higher than that in the treatment group The positive rate of TP-DNA was 3.70%, the difference was statistically significant (P <0.05). The women with syphilis were divided into three groups according to the serum RPR titer of 1: 2, 1: 4 to 1: 8 and 1:16 . The positive rates of TP-DNA in serum, urine and vaginal secretions of the three groups were compared. The positive rates of TP-DNA in each group were statistically significant (P <0.05). The positive rate of serum TP-DNA was positively correlated with serum RPR titer (r = 0.710, P <0.05). Conclusion Treponema pallidum exists in the serum, urine and vaginal secretions of female syphilis patients. After treatment, some TP-DNA positives were detected in serum, urine and vaginal secretions. Body fluid is also an indirect source of syphilis infection.