TP0453、TP17在梅毒患者血清中的表达及相关性研究

发布时间：2018-10-11 19:32

【摘要】：目的：通过了解一期梅毒、二期梅毒、隐性梅毒（也称为潜伏梅毒）及血清固定型梅毒患者血清中TP0453、TP17抗原特异性的差异表达状况，得出不同期梅毒浓度表达数值，比较性研究各期梅毒患者两种抗原浓度表达差异的特点，探索它们之间的相关性及所反映的意义，进一步探讨一种更为快速、简便、特异性好及敏感性高的梅毒血清学诊断方法。方法：根据梅毒临床诊断标准，收集符合要求的全部80例病例，按照入组标准采用随机病例对照研究方法将病例分为实验组四组，即一期梅毒组20例，二期梅毒组20例，隐性梅毒组20例及血清固定组20例；正常对照组一组，（即未感染的健康志愿者）病例16例。分别采集正常对照者、一期梅毒、二期梅毒、隐性梅毒及血清固定型梅毒患者的外周血，对其分离血清，采用酶联免疫分析吸附（Enzyme-LinkedImmunoSorbentAssay，ELISA）方法检测各型梅毒患者及正常对照者血清中的TP0453、TP17抗原特异性表达状况，根据标准品的浓度和OD值得出直线回归方程式并计算出各期梅毒两种抗原的平均浓度数值，应用SPSS20.0软件包对资料进行统计分析。结果：⑴TP0453在各型梅毒血清中平均浓度表达由高到低依次为一期梅毒为95.272±1.43，血清固定型梅毒为73.467±1.86，二期梅毒为45.587±1.94，隐性梅毒为37.261±2.79，健康对照组为16.101±1.77。⑵TP17在各型梅毒血清中平均浓度表达由高到低依次为一期梅毒为44.171±2.96，二期梅毒为36.879±1.39，血清固定型梅毒为33.886±3.77，隐性梅毒为26.207±2.65，健康对照组为20.14±2.78。⑶同种抗原浓度表达在各期梅毒血清中的两两比较：TP0453浓度表达在一期梅毒和其余各期梅毒中比较均有P＜0.05，差别有统计学意义，其余各期梅毒比较的伴随概率P＞0.05，无明显统计学差异；TP17浓度表达在各期梅毒两两比较中均有P＞0.05，无明显统计学差别。⑷两种抗原各期梅毒浓度表达与健康组比较均有P＜0.05，差别有统计学意义。结论：1.TP0453在一期梅毒中有较高浓度的表达，尤其在伴有二期梅毒疹或其它体征的患者血清中呈高浓度表达，为梅毒早期诊断提供了一种重要的实验室检测手段。2.血清固定型梅毒中浓度表达增高，是否提示该抗原与血清固定存在某种关联，有待于进一步深入研究。3.二期和隐性梅毒中该抗原的浓度表达无明显差异，其原因有待于进一步研究。4.TP17除在一期梅毒中有稍高浓度表达外，其余各期梅毒中呈低浓度表达且各期间均无明显统计学差异，特别是治疗后也无明显的浓度变化，，故此抗原可能对梅毒有一定的特异性诊断意义。5.梅毒患者各期和健康组比较，两种抗原浓度表达均有P＜0.05，具有明显统计学差异。
[Abstract]:Objective: to investigate the differential expression of TP0453,TP17 antigen in patients with primary syphilis, secondary syphilis, recessive syphilis (also known as latent syphilis) and serum fixed syphilis. To compare the characteristics of the expression of two antigens in patients with syphilis at different stages, to explore the correlation between them and their significance, and to further explore a more rapid and convenient method for syphilis. Serological diagnosis of syphilis with good specificity and high sensitivity. Methods: according to the criteria of clinical diagnosis of syphilis, all 80 cases of syphilis were collected. According to the standard of admission, the cases were divided into four groups: the first syphilis group (20 cases), the secondary syphilis group (20 cases), and the second syphilis group (20 cases). There were 20 cases in recessive syphilis group and 20 cases in serum fixation group and 16 cases in normal control group. Peripheral blood samples were collected from normal controls, primary syphilis, secondary syphilis, recessive syphilis and serum fixed syphilis. Enzyme linked immunosorbent assay (Enzyme-LinkedImmunoSorbentAssay,ELISA) was used to detect the specific expression of TP0453,TP17 antigen in the sera of syphilis patients and normal controls. According to the concentration of standard sample and OD, the linear regression equation and the average concentration of two antigens in each stage of syphilis were calculated. The data were analyzed by SPSS20.0 software package. Results: the average expression of 1TP0453 was 95.272 卤1.43 in primary syphilis, 73.467 卤1.86 in fixed syphilis, 45.587 卤1.94 in secondary syphilis, 37.261 卤2.79 in recessive syphilis, and 16.101 卤1.77.2TP17 in healthy control group. The average expression of homoantigen was 44.171 卤2.96 in primary syphilis, 36.879 卤1.39 in secondary syphilis, 33.886 卤3.77 in serum fixed syphilis, 26.207 卤2.65 in recessive syphilis, and 20.14 卤2.78.3 in healthy controls. The expression of TP0453 in primary syphilis was significantly higher than that in other syphilis (P < 0.05). The concomitant probability of syphilis in other stages was not significantly different (P > 0.05). The expression of TP17 in each stage of syphilis had no significant difference (P > 0.05). 4 the expression of TP17 in each stage of syphilis was significantly higher than that in the healthy group (P < 0.05). Conclusion: 1.TP0453 is highly expressed in primary syphilis, especially in patients with secondary syphilis or other signs, which provides an important laboratory method for early diagnosis of syphilis. 2. Whether the high expression of serum fixed syphilis suggests that there is a certain association between the antigen and serum fixation needs to be further studied. 3. There was no significant difference in the expression of the antigen between the secondary syphilis and the recessive syphilis, the reasons for which were to be further studied. Except for the slightly high expression of 4.TP17 in the primary syphilis, the other syphilis had a low concentration expression and no significant difference in each period. Especially after treatment, there is no obvious change of concentration, so antigens may have a certain specific diagnostic significance for syphilis. 5. The expression of antigens in syphilis patients was significantly higher than that in healthy controls (P < 0.05).
【学位授予单位】：泸州医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R759.1

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