苯丙胺类兴奋剂对梅毒患者远期预后的影响

Influence of Amphetamine-type Stimulants on Long-term Prognosis in Patients with Syphilis

目的观察苯丙胺类兴奋剂对梅毒患者治疗后2年内预后的影响。方法收集55例吸食苯丙胺类毒品的梅毒患者,经过规范治疗后对其定期随访,于治疗后2年时取患者外周血检测RPR滴度和免疫球蛋白水平,检测外周血单个核细胞产生IFN-γ和IL-4的水平,并与55例梅毒患者和30例正常人作比较。结果实验组治疗后2年内RPR阴转率为69.10%,明显低于对照组(P<0.05)。RPR未转阴的梅毒患者,无论是否吸毒,IFN-r水平均低于已转阴的患者和正常对照组(P<0.05),而免疫球蛋白和IL-4水平比较,差异无统计学意义(P>0.05),RPR已转阴的梅毒患者,无论是否吸毒,免疫球蛋白、IFN-γ和IL-4水平与正常对照组相比,差异均无统计学意义(P均>0.05)。结论苯丙胺类兴奋剂降低了梅毒患者的临床治愈率。

Objective To evaluate the influence of amphetamine-type stimulants on prognosis in patients with syphilis after 2 years of treatment. Methods Fifty-five patients with syphilis who took amphetamine-type stimulants （ATS） were recruited in this study together with 55 patients with syphilis who never took ATS and 30 normal human controls. Benzathine benzyl penicillin was given intramuscularly to all patients at a dose of 2 400 000 unit per week for 3 weeks. Follow up regularly after the therapy for two years. The entire laboratory tests were performed on the 24 month after the therapy. Rapid plasma regent （RPR） was performed among all the patients. Radio immune assay and nephelometry were used to detect the serum level of lgG, IgM and lgA. ELISA methed was used to evaluate the capability of peripheral blood mononuelear cells （PBMCs） producting IFN-γand IL-4 ELISA. Results The RPR negative conversion rate in the stimulant-taking group was 69.10% , which was significantly lower than that in the non-taking group （ P 〈 0.05 ）. The capability of PB- MCs to produce IFN-γwas lowest in the patients whose RPR were positive, no matter taking stimulants or not compared with the patients whose RPR were negative and the normal human controls. As for the serum level of IgG, IgM, IgA and the capability of PBMCs to produce IL-4 among all the groups were no significant difference compared with the normal human controls （ P 〉 0.05 ）. Conelusion Amphetamine-type stimulants could reduce the clinical cure rate of the natients with syphilis.