90例早期梅毒患者治疗前后的临床及血清学结果分析

Analysis of clinical and serological results in 90 cases of early syphilis

目的分析早期梅毒的临床特征和血清学变化,为梅毒的诊断和疗效观察提供参考依据;方法追踪观察90例早期梅毒患者,对其临床资料进行回顾性分析;结果 90例梅毒患者血清TPPA检测结果均为阳性,一期梅毒患者血清RPR滴度为1：4者最多,为9例（25.7%）;二期梅毒患者RPR滴度为1：32者最多,为13例（41.9%）;早期潜伏梅毒患者RPR滴度为1：8者最多,为6例（28.6%）;在所有病例中,血清滴度为1：8及1：16的患者人数最多,分别为18例（20.0%）和19例（21.1%）。一期梅毒患者治疗后硬下疳多在2周内消失,二期梅毒患者治疗后皮损多在（1~2）周消失,早期潜伏梅毒患者治疗后未见异常。经治疗后,多数患者（95.6%）血清RPR滴度在24个月内阴转;结论多数梅毒具有典型的皮损,血清学检查是诊断梅毒和观察疗效的重要指标,早期的正规治疗效果较好。

Objective To analyse the clinical features and serological changes of early syphilis,providing the reference for the diagnosis and effective observation of syphilis. Methods Retrospectively analysis clinical data of 90 patients with early syphilis. Results All TPPA results in serum of 90 patients with syphilis are positive. The serum RPR titer of most primary syphilis is 1： 4,which is 9 cases（ 25.7%）; among secondary syphilis patients,1： 32 titer is the highest,that is 13 cases（ 41.9%）; and in patients with early latent syphilis 1： 8 titer is the highest,which is 6cases（ 28.6%）; among all the cases,the patients with the serum RPR titer 1： 8 and 1： 16 occupied most proportion,they are 18 cases（ 20%） and 19 cases（ 21. 1%） respectively. The hard chancre disappeared after 2 weeks ＇treatment for most primary syphilis patients; skin lesions of secondary syphilis patients were cured in 1 ~ 2 weeks; and there were not obvious abnormality in early latent syphilis patients after treatment. The serum RPR titers of the majoy patients（ 95.6%） turn negative in 24 months after treatment. Conclusion The majority of patients have typical skin lesions,serological examination is an important index for the diagnosis and effective observation,the early and formal treatment could gain better effectiveness.