Cov cim qhia dav dav thiab kev siv tshuaj ntsuam xyuas kev kuaj mob syphilis

Cov cim qhia ntawm kev kuaj mob syphilis

Syphilis hu ua "simulation master" los ntawm cov kws kho mob dermatologist vim muaj ntau hom kev kho mob tshwm sim. Tam sim no, kev kuaj mob syphilis feem ntau yog txiav txim siab los ntawm kev ntsuam xyuas serological vim tsis muaj cov khoom siv nrov xws li chaw tsaus lossis fluorescence microscope. Cov txheej txheem kuaj tau muab faib ua ob pawg vim muaj ntau txoj kev npaj antigen:

1. Non-Treponema pallidum antigen test, suav nrog: (1) Non-Treponema pallidum serum test Cov antigens ntawm hom kev kuaj no tau muab faib ua cardiolipin, lecithin thiab cholesterol ncua, uas yog siv los kuaj cov tshuaj tiv thaiv kab mob anticardiolipin. Txij li thaum cov kev ntsuam xyuas no muaj tib tus qauv antigen, qhov rhiab heev zoo ib yam. Muaj peb feem ntau siv: ① venereal kab mob tshawb fawb kuaj swb (VDRL); ② cov kua dej tsis huv reagin swb xeem (USR); ③ ceev ceev plasma reagin nplhaib daim npav kuaj (RPR). Nws tuaj yeem siv rau kev tshuaj ntsuam xyuas thiab tuaj yeem siv ntau rau kev soj ntsuam cov nyhuv curative.

2. Treponema pallidum antigen test, suav nrog: ① Fluorescent Treponema pallidum antibody absorption test (FTA-ABS); ② Treponema pallidum hemagglutination test (TPHA); ③ Treponema pallidum brake test (TPI), thiab lwm yam. Cov kev ntsuam xyuas no tshwj xeeb heev thiab feem ntau yog siv rau kev kuaj mob.

Hauv kev kuaj thawj zaug, VDRL tsis tau ua hauv tsev kho mob feem ntau vim muaj kev ua haujlwm nyuaj. USR thiab RPR yog kev txhim kho kev sim raws li VDRL. Kev ua haujlwm yog yooj yim thiab cov txiaj ntsig tuaj yeem txiav txim nrog qhov muag liab qab. Lawv muaj qhov tshwj xeeb thiab rhiab heev, yog li lawv tau siv dav. .

Nyob rau hauv qhov kev ntsuam xyuas pom zoo, TPHA thiab TPPA tau dav ua tiav vim lawv txoj haujlwm yooj yim, tshwj xeeb thiab rhiab heev dua li FTA-ABS. Feem ntau hais lus, tsis suav nrog qhov ua rau muaj qhov tsis zoo thiab lees paub cov tshuaj tiv thaiv-IgG Treponema pallidum antibody hauv qhov kev sim, txawm tias kev kho mob txaus, qhov tshwm sim tseem tuaj yeem ua tau zoo, yog li nws yuav tsum tsis txhob siv los ua lub hauv paus rau kev soj ntsuam cov nyhuv curative. , rov ua dua thiab rov kho dua.

False positives and false negatives yog "loj"

Vim yog vim li cas, ob hom kev kuaj mob syphilis serological muaj teeb meem lom-zoo thiab tsis tseeb-tsis zoo. Xws li: kab mob lupus erythematosus, kab mob rheumatic, mob caj dab, daim siab cirrhosis, mob qog noj ntshav, kev siv tshuaj hauv cov hlab ntsha, cev xeeb tub, ntshav qab zib, rubella, filariasis, tuberculosis thiab lwm yam kab mob sib kis thiab mob ntev tuaj yeem ua rau muaj qhov tsis zoo. Cov txiaj ntsig zoo li no muaj qhov qis qis heev tom qab ob npaug ntawm qhov kev sib tw, feem ntau hauv qab 1: 8, uas tuaj yeem qhia meej los ntawm kev sib txuas ob hom kev xeem. Vim qhov kev sim rhiab heev, qhov tshwm sim prozone (siab concentration ntawm Treponema pallidum antibody inhibits antigen-antibody agglutination), thiab qhov ntev ntawm tus kab mob syphilis tuaj yeem ua rau cov txiaj ntsig tsis zoo, xws li: RPR cov txiaj ntsig zoo rau thawj thiab qib syphilis yog feem 85. yog 80 % , . Qhov tsis zoo thiab qhov tsis zoo tsis tseeb tuaj yeem txiav txim siab ua ke nrog cov ntaub ntawv kho mob thiab rov kuaj dua.

Yuav saib xyuas cov txiaj ntsig zoo li cas

Thaum peb saib cov txiaj ntsig ntawm kev kuaj mob syphilis, peb yuav tsum muab cov kev ntsuam xyuas ua ntej, kev kuaj pom tseeb thiab kev txheeb xyuas tag nrho ntawm cov ntaub ntawv kho mob thiab kis mob ntawm tus neeg mob. Feem ntau, cov neeg mob uas muaj qhov zoo RPR thiab USR cov kev ntsuam xyuas hauv qhov kev ntsuam xyuas thawj zaug thiab cov kev kuaj pom tsis zoo tsis suav nrog kev kis kab mob. Yog tias qhov kev ntsuam xyuas pom tau zoo rau TPI lossis TPHA, tab sis qhov kev kuaj thawj zaug tsis zoo, nws raug suav tias yog qhov tsis zoo lossis tus kab mob syphilis tau kho (ob peb tus neeg mob tuaj yeem kho tsis tau kho). Cov neeg mob syphilis yuav tsum tau ua raws li 2 xyoos tom qab kev kho tus qauv. Qhov kev kuaj tsis yog Treponema pallidum raug tshuaj xyuas txhua 3 lub hlis hauv thawj xyoo, thiab txhua rau lub hlis hauv xyoo ob. , tuaj yeem suav hais tias yog serofixed thiab kho mob. Yog hais tias tus titer nce nyob rau hauv kev soj ntsuam xyuas, nws raug suav hais tias yog rov ua dua lossis rov ua dua tshiab, thiab kev sab laj lossis kev kho mob nrog tus kws kho mob tshwj xeeb yuav tsum tau.