54例梅毒血清固定患者临床分析及细胞免疫功能检测

Clinical analysis of cellular immunity of 54 seroresistance syphilis patients

目的通过临床分析及细胞免疫功能检测,探索梅毒血清固定发生的相关因素。方法选择54例梅毒血清固定患者,分析梅毒血清固定的发生与甲苯胺红不加热血清反应素试验(TRUST)初始滴度、疾病分期、治疗用药的关系。应用流式细胞仪检测54例梅毒血清固定患者与32例正常健康对照组外周血淋巴细胞亚群比例。结果一期梅毒血清固定者占1.85%(1/54),二期梅毒占11.11%(6/54),隐性梅毒占87.04%(47/54);梅毒血清固定患者中51例均应用苄星青霉素规范驱梅治疗,2例因青霉素过敏应用四环素替代治疗,1例一期梅毒应用罗氏芬治疗;与健康对照组相比,梅毒血清固定患者CD4+细胞比例(32.37±5.49)及NK细胞比例(18.39±7.93)均显著低于健康对照组(37.34±8.19,P<0.05;22.84±8.47,P<0.05)。结论隐性梅毒患者血清固定发生率高。CD4+T细胞及NK细胞减少可能与梅毒血清固定有关。

Abstract：Objective To investigate the relevant factors of seroresistance of syphilis by clinical analysis and study of immunological function. Methods The clinical data of 54 patients with seroresistance syphilis were analyzed to detect the correlation of seroresistance factors including original titer of TRUST, disease course and medication. Flow eytometry was used to detect the proportions of T-lymphocytes subset in the peripheral blood of these seroresistance syphilis patients and 32 healthy volunteers. Results The seroresistance rate was 1.85% in the primary syphilis patients （1/54）,11.11% in the secondary syphilis patients （6/54）and 87.4% in the latent syphilis patients （47/54）. 51 seroresistance patients were treated with benzathine penicillin,2 patients were cured with tetracycline because of allergy to penicillin and 1 primary syphilis patient was prescribed with Ceftriaxone. The proportion of CD4＋T cell （32.37± 5.49） and NK cell （18.39 ± 7.93） in semresistance patients were significant lower than those in health control group（37.34 ±8.19, P〈0.05 ;22.84 ±8.47, P〈0.05 ） respectively. Gonclusions Latent syphilis was prone to create seroresistance. The decrease of CD4＋T cells and NK cells may play an important role in seroresistance.