近10年梅毒血清固定患者临床分析

Clinical analysis of sero-resistance of syphilis in the past decade

目的:研究梅毒血清固定现象及其相关影响因素。方法:回顾过去10年的梅毒患者资料,所有患者均采用苄星青霉素240万U(每周1次,连续3次)肌内注射治疗,统计梅毒血清固定的发生率和形成时间,用多因素逐步回归方法分析梅毒血清固定与患者年龄、性别、梅毒分期、血清快速血浆反应素(RPR)试验初始滴度等因素的关系,并作前、后5年的比较。结果:423例梅毒患者2年内RPR试验阴转率为82.5%,有74例(17.5%)出现血清固定,其中一期梅毒血清固定发生率为3.8%,二期梅毒为17.5%,潜伏梅毒为40.5%;多因素逐步回归分析结果表明,梅毒分期是与血清固定发生有显著性意义的相关因素,在过去10年中,后5年各期梅毒患者的血清固定发生率都有不同程度增加,特别是潜伏梅毒患者的血清固定发生率显著增高(P<0.01)。结论:病期不明的潜伏梅毒增多是后5年潜伏梅毒患者血清固定发生率显著增高的主要原因,加强对潜伏梅毒的筛查和及时治疗是减少梅毒血清固定形成的关键。

Objective： To study sero-resistance phenomenon of syphilis and correlative factors. Methods： The clinical data of patients with syphilis in the recent ten years were reviewed, the incidence and the duration of occurrence of sero-resistance of syphilis, the relationship between the incidence of sero-resistance and age, sex, the stage of disease, the RPR initial titer of the patients were analyzed respectively by multiple regression assay. The data of the first half decade were compared with the last five years. Results： Negative rate of RPR test was 82.5% two years post treatment in 423 patients, and 74 （17.5%） cases became sero-resistant. The incidences of sero-resistance were 3.8%, 17.5%, 40.5% in primary syphilis, secondary syphilis and latent syphilis respectively. Multiple regression analysis showed that the stage of disease was the signifi-cant factor in the development of sero-resistance. The incidence of sero-resistance in the patients with syphilis, particularly latent syphilis, increased significantly during the last five years （P 〈 0.01）. Conclusions： Increasing the number of the patients with latent syphilis of undetermined disease duration might be the main reason for the increasing of the incidence of sero-resistance in syphilis during the last five years. Strengthening screening and timely treatment of patients with syphilis are the key points to reduce sero-resistance of syphilis.