梅毒治疗与未治疗情况下FTA-ABS-IgM和VDRL检测的定量评估。
Quantitative evaluation of the FTA-ABS-IgM and VDRL test in treated and untreated syphilis.
作者信息
Luger A, Schmidt B, Spendlingwimmer I
出版信息
Br J Vener Dis. 1977 Oct;53(5):287-91. doi: 10.1136/sti.53.5.287.
Observations made on fluorescent treponemal antibody absorption (FTA-ABS) immunoglobulin M (IgM) titres in patients with untreated early syphilis showed non-reactive or weakly reactive results in patients with primary (one of five cases) and secondary (two of 16 cases) lesions. In patients with primary (19.5%) and secondary (15%) syphilis sera remained reactive with increased titres for more than one year after treatment. The respective figures in the results of the Venereal Disease Research Laboratory (VDRL) test were zero in primary and 20% in secondary syphilis. The non-reactive FTA-ABS IgM results may possibly be explained by competitive inhibition of IgM by immunoglobulin G (IgG). The persistence of reactivity in a comparable percentage has been observed by other investigators (Grin et al., 1974; Wilkinson and Rodin, 1976). The current results therefore suggest that FTA-ABS IgM titres are less reliable for assessing the effect of treatment than the course of the VDRL titres. The phenomenon of a decrease in FTA-ABS IgM titres soon after treatment with a later rise before final non-reactivity is a matter for further investigation.
对未经治疗的早期梅毒患者进行荧光密螺旋体抗体吸收试验（FTA-ABS）免疫球蛋白M（IgM）滴度观察发现，一期梅毒患者（5例中有1例）和二期梅毒患者（16例中有2例）的检测结果为无反应或弱反应。一期梅毒患者（19.5%）和二期梅毒患者（15%）在治疗后一年多时间里，血清一直呈反应性且滴度升高。性病研究实验室（VDRL）试验结果中，一期梅毒的相应数字为零，二期梅毒为20%。FTA-ABS IgM无反应结果可能是由免疫球蛋白G（IgG）对IgM的竞争性抑制所导致。其他研究人员（格林等人，1974年；威尔金森和罗丁，1976年）也观察到了类似比例的反应性持续存在。因此，目前的结果表明，与VDRL滴度的变化过程相比，FTA-ABS IgM滴度在评估治疗效果方面不太可靠。治疗后FTA-ABS IgM滴度很快下降，随后在最终无反应之前又出现上升，这一现象有待进一步研究。
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