早期梅毒治疗前后血清学分析

Serological analysis before and after the treatment of early syphilis

目的探讨早期梅毒治疗前后血清学变化。方法 92例早期梅毒患者,均采用苄星青霉素肌内注射治疗,分别于治疗前及治疗后3、6、12个月行血清学检测[梅毒血浆反应素快速试验(RPR)、梅毒螺旋体明胶颗粒凝集试验(TPPA)],分析治疗前后血清学检测结果。观察25例玫瑰疹患者和20例扁平湿疣患者皮损消失时间。结果 RPR检测:治疗后3个月7例阳性,治疗后6个月4例阳性,治疗后12个月2例阳性;TPPA检测:治疗后3个月91例阳性,治疗后6个月91例阳性,治疗后12个月91例阳性。25例玫瑰疹患者在治疗2 d 88.0%消退,余下12.0%在治疗7 d及以上消退;20例扁平湿疣患者在治疗3 d 60.0%开始消退,30.0%治疗5 d消退,10.0%治疗7 d及以上消退。结论血清学反应是诊断及判断早期梅毒疗效的重要指标,而早期梅毒积极治疗具有较好的效果。

Objective To investigate the serological changes before and after the treatment of early syphilis. Methods 92 patients with early syphilis were treated with intramuscular injection of benzyl penicillin, serological detection [rapid plasma reagin（RPR） test for syphilis, treponema pallidum gelatin particle agglutination test（TPPA）] before treatment and 3, 6, 12 months after treatment were carried out. Serological test results before and after treatment were analyzed. The time of skin loss was observed in 25 cases of rose eruption and 20 cases of condyloma acuminatum. Results RPR test： 7 cases were positive in 3 months after treatment, 4 cases were positive in 6 months after treatment, 2 cases were positive in 12 months after treatment. TPPA test： 91 cases were positive in 3 months after treatment, 91 cases were positive in 6 months after treatment, 91 cases were positive in 12 months after treatment. In 25 cases of rose eruption, 88% disappeared after 2 days of treatment, and the remaining 12% disappeared after 7 days of treatment or more. In 20 cases of condyloma latum, 60.0% disappeared after 3 days of treatment, 30.0% disappeared after 5 days of treatment, and the remaining 10.0% disappeared after 7 days of treatment or more. Conclusion Serological response is an important indicator to diagnose and judge the effect of early syphilis, while active treatment of early syphilis has a good effect.