头孢曲松钠治疗早期神经梅毒临床分析

Efficacy of ceftriaxone sodium in treatment of early neurosyphilis patients

目的探讨头孢曲松钠治疗早期神经梅毒的临床疗效。方法对早期梅毒(一、二期梅毒)患者进行血清学及脑脊液检查,将确诊的28例无症状神经梅毒和4例梅毒性脑膜炎随机分成两组,均住院接受治疗,其中头孢曲松钠组17例,予头孢曲松钠2g/d静脉滴注,连续14d;青霉素组15例,应用水剂青霉素治疗,400万U/次静脉滴注,每4h一次,连续14d。结果治疗后6个月,头孢曲松钠组和青霉素组血清学RPR滴度分别有16例(94.1%)、14例(93.3%)不同程度的下降,其中分别有7例(41.2%)、7例(46.7%)下降4倍及以上。CSF RPR滴度分别有9例(52.9%)、8例(53.3%)出现下降;治疗后12个月两组分别有14例(82.4%)、13例(86.7%)血清学及CSF RPR同时转阴;治疗后18个月两组分别有16例(94.1%)、14例(93.3%)血清学及CSF RPR转阴,各有1例仍未转阴,但血清学RPR滴度持续下降,目前仍在随访。两组差异无统计学意义(P>0.05)。结论头孢曲松钠可以替代水剂青霉素,作为治疗早期神经梅毒的有效药物。

Objective To investigate the clinical efficacy of ceftriaxone sodium in the treatment of early neurosyphilis.Methods Serum and cerebrospinal fluid examination of primary and secondary syphilis patients were conducted and 28confirmed asymptomatic neurosyphilis and 4 meningeal syphilis cases were divided into two groups, including ceftriaxonesodium group （17 cases） treated with ceftriaxone sodium intravenous infusion of 2g/d, continuous for 14 days and penicillingroup （ 15 cases） treated with penicillin of four million unit intravenous drip, once every four hours continuously for fourteendays. Results After treatment for 6 months, serum RPR titers of 16 cases （94.1%）in ceftriaxone sodium group and 14 cases（93.3%） in penicilhn group were decreased in varying degrees, a drop of 4 folds or more was noticed in 7 cases （41.2%） ofceftriaxone sodium group and 7 cases （46.7%） in penicillin group. A reduction of CSF RPR titers were observed in 9 cases（52.9%） and 8 cases （53.3%）, serum negative and CSF negative were observed in 14 cases （8：2.4%） and 13 cases （86.7%）12months after treatment in two groups. And 18 months after treatment serum negative and CSF negative were observed in 16cases （94.1%） and14 cases （93.3%） in two groups. But there was a case under follow-up did not converse negative serologicallythough the serum RPR titre continued to decline. No statistical significant differences in negative conversion of serum RPRtitres between the two groups were recorded （P〉0.05）. Conclusion Ceftriaxone sodium can replace penicillin as an effectivedrug for treatment of patients with early neurosyphilis.