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[脑脊液中梅毒螺旋体被动微量血凝反应在神经梅毒诊断中的应用]

[Passive microhemagglutination reaction to Treponema pallidum in the cerebrospinal fluid in the diagnosis of neurosyphilis].

作者信息

Machado A de B, Bassi G E, Da Silva S M, Guglielmo S

机构信息

Laboratório Central, Hospital das Clinicas, São Paulo SP - Brasil.

出版信息

Arq Neuropsiquiatr. 1988 Dec;46(4):369-73. doi: 10.1590/s0004-282x1988000400005.

Abstract

A quantitative micro-hemagglutination test for antibodies to Treponema pallidum (MHA-TP) was evaluated in 25 cerebrospinal fluid (CSF) samples obtained from patients with neurosyphilis (NS group) and in 7 CSF samples of patients with reactive serologic tests for syphilis (STS+). These data were compared to treponemal and nontreponemal tests. The MHA-TP was reactive in all of the 25 NS group samples, the FTA-Abs and the complement fixation of Wassermann (CFW) were in 24 and the VDRL in only 9. In the 7 STS+ samples (STS+ group), the MHA-TP was reactive in 6, the FTA-Abs in all of them and the nontreponemal tests were nonreactive. Results analyses support conclusion the clinical diagnosis of NS must be complemented by cytoproteic dual and immunological treponemal and nontreponemal assays in CSF. The MHA-TP test was as sensitive as FTA-Abs and required less technical and interpretative skills, contributing in association to CFW to NS diagnosis.

摘要

对25份取自神经梅毒患者的脑脊液(CSF)样本(神经梅毒组)以及7份梅毒血清学反应性检测(STS+)患者的脑脊液样本,评估了梅毒螺旋体抗体定量微量血凝试验(MHA-TP)。将这些数据与梅毒螺旋体检测和非梅毒螺旋体检测进行比较。MHA-TP在神经梅毒组的所有25份样本中呈阳性反应,荧光密螺旋体抗体吸收试验(FTA-Abs)和瓦色曼补体结合试验(CFW)在24份样本中呈阳性反应,而性病研究实验室试验(VDRL)仅在9份样本中呈阳性反应。在7份STS+样本(STS+组)中,MHA-TP在6份样本中呈阳性反应,FTA-Abs在所有样本中呈阳性反应,而非梅毒螺旋体检测均为阴性反应。结果分析支持如下结论:神经梅毒的临床诊断必须辅以脑脊液中的细胞保护双重检测以及梅毒螺旋体和非梅毒螺旋体免疫检测。MHA-TP试验与FTA-Abs一样敏感,且所需的技术和解读技能较少,与CFW一起有助于神经梅毒的诊断。

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