青霉素治疗麻痹性痴呆的临床疗效观察

Observation the clinical efficacy of the penicillin treatment of paralytic dementia

目的 研究青霉素治疗麻痹性痴呆的临床疗效.方法 将笔者所在医院88例确诊为麻痹性痴呆的患者随机分为两组（常规组43例和延长组45例）,两组患者先完成常规治疗：用大剂量青霉素G（2 240万U/d）治疗14 d,继之以苄星青霉素G240万U肌注,1次/周,连续3次 常规组结束疗程,而延长组再以苄星青霉素G240万U肌注,1次/周,连续6个月.然后分析两组患者在完成常规治疗后6个月内复发的情况,并进行统计学分析.结果 在完成常规治疗后6个月内,常规组有20例复发（46.51%）,而延长治疗组在后续的6个月内仅有5例复发（11.11%）,两组比较差异有统计学意义（P〈0.001）.讨论 麻痹性痴呆是由梅毒螺旋体直接侵犯神经组织导致的,临床特征为进行性痴呆和神经征象.青霉素是治疗神经梅毒疗效肯定的唯一药物,使用大剂量青霉素对麻痹性痴呆的患者进行常规治疗或延长治疗后,延长组患者复发率明显减少.从而证明与常规治疗方案相比,延长治疗组临床治疗效果更好.

Objective To study the clinical efficacy of penicillin treatment of paralytic dementia. Methods The hospital diagnosed 88 cases of paralytic dementia patients who were randomly divided into two groups （ conventional group of 43 cases and extended group of 45 cases） , two groups of patients in first complete the conventional treatment： with large doses of penicillin G （22 400 000 U/day） treatment for 14 days followed by benzathine penicillin G2 400 000 U intramuscularly injection, 1 times/week for 3 consecutive times; the end of conventional treatment group, but to extend the group longer G2 400 000 U benzathine penicillin intramuscular injection, 1 times/week, 6 consecutive months. Then analyzes the two groups of patients who completed the treatment within 6 months after the recurrence of the situation and were statistically analyzed. Results Upon completion of conventional therapy, within 6 months after the conventional group, 20 cases of relapse （46. 51% ） , while the extension of the treatment group in the follow - up within 6 months with only five cases of relapse （ 11. 11% ）, the two groups was significant differences （ P 〈 0. 001 ）. Conclusion Paralytic dementia is a direct violation of Treponema pallidum nerve tissue, its clinical features of progressive dementia and neurological signs. Penicillin is the treatment of neurosyphilis positive effect of the only drugs, the use of large doses of penicillin on the paralytic routine treatment of patients with dementia or extended treatment to extend the group of patients relapse rate decreased significantly. Thus proving the program note, extended group compared with conventional treatment group has better efficacy.