Benzathine penicillin G in the treatment of syphilis

Post-treatment observation of two years'' duration has confirmed preliminary data which indicated that a single injection of 2.5 million units of benzathine penicillin G, in early infectious syphilis, produces results equal, if not superior, to those obtained with schedules employing 4.8 million units of procaine penicillin and aluminium monostearate.     

Long-term studies of results of penicillin therapy in early syphilis

In 1945, the US Public Health Service and co-operating treatment centres began a study of the results of penicillin therapy in a group of syphilis patients selected for intensive post-treatment observation. One objective was to test the hypothesis that patients lapsing from follow-up have the same experience as those remaining under observation, and evidence is presented which indicates that this is the case. The major objective was to evaluate the long-term results of penicillin in early syphilis. At the sixth year following penicillin treatment, satisfactory results were recorded for 98%-99% of the patients with primary and secondary syphilis (including those re-treated). There is no evidence that the cure of syphilis is enhanced by the addition of arsenic and bismuth. Seronegativity rates at the sixth post-treatment year were 81.0% for patients given combined penicillin-arsenic-bismuth therapy, and 80.7% for those treated with penicillin alone, while re-treatment rates were 17.4% and 16.3%, respectively. When cases treated with “adequate” dosage of arsenic and bismuth are analysed by the same statistical method as that employed in evaluating penicillin, the superiority of penicillin is clearly evident. A minimum of 4,800,000 units of penicillin is recommended for the treatment of early infectious syphilis.     

妊娠梅毒和先天梅毒

梅毒是一个全球性公共卫生问题 ,可导致严重的妊娠不良结局。通过适当的产前检查 ,识别感染梅毒的高危孕妇和婴儿 ,给予合理的治疗和足够的随访 ,能够在一定程度上遏制梅毒的传播。该文重点对妊娠梅毒和先天梅毒的流行病学现状、筛查和治疗进展等方面加以综述。     

妊娠梅毒与先天梅毒

妊娠梅毒和先天梅毒逐渐成为危害母婴健康的重要传染性疾病之一。妊娠期梅毒螺旋体能通过胎盘引起胎儿发育不良,甚至死胎、死产。妊娠期梅毒感染的危险因素与发病年龄、文化程度、多性伴史、居住地等有关。胎儿宫内感染状况与感染母亲的病程及妊娠期治疗时间有关。因此,进一步了解妊娠梅毒和先天梅毒的感染危险因素,明确妊娠梅毒和先天梅毒的筛查和诊断标准、治疗方法及预后效果,对于有效地控制梅毒的母婴传播,预防和治疗梅毒宫内感染的不良后果,降低先天梅毒的发病率具有重要意义。     

梅毒血清学试验在梅毒诊断中的应用

目的评价3种梅毒血清学试验在梅毒诊断中的应用价值。方法对65份梅毒阳性血清和96份健康体检阴性的血清用苍白密螺旋体血凝试验(TPHA)、梅毒酶联免疫吸附试验(TP-ELISA)和苍白密螺旋体抗体明胶颗粒凝集试验(TPPA)3种方法进行检测。结果 3种方法检测65份梅毒血清中,TRUST阳性61份,阳性率为93.8%;TP-ELISA阳性63份,阳性率为96.9%;TPPT阳性65份,阳性率100.0%;3种方法检测96份健康者血清,TRSUT和TP-ELISA均检出生物假阳性。结论 TRUST敏感性、特异性均最低,TP-ELISA敏感性和特异性高于TRUST,TPPA敏感性和特异性最高;TRSUT对于非特异性的梅毒血清学试验,仅可作为疗效观察和随访有无复发或再感染的指标。     

Untoward penicillin reactions

The literature on untoward reactions following the administration of penicillin is reviewed. These reactions, including a certain number of deaths which have been reported, are of particular interest to health administrations and to WHO in view of the large-scale programmes for controlling the treponematoses which are now under way—programmes affecting millions of people in many parts of the world.     

妊娠梅毒早期干预 预防早期先天梅毒

为了解妊娠梅毒垂直传播情况 ,做到早期诊断 ,早期治疗 ,运用梅毒非特异性试验先进行筛选 ,然后用特异性试验进行梅毒确诊 ,筛选出真正的梅毒感染者 ,排除假阳性 ,并给予及时治疗。结果表明 ,2 3例梅毒感染孕妇所分娩的 2 3例新生儿无一例甲苯胺红 (TRUST)试验阳性滴度高于母亲的 4倍 ,新生儿 Apgar评分、体重大多数正常 ,无一例死胎 ,无先天梅毒的临床表现     

潜伏梅毒(隐性梅毒)研究近况

复习近年来潜伏梅毒(隐性梅毒)研究的部分文献,综述潜伏梅毒的定义、发现途径、发生的原因、危害性、检测和治疗、护理.发现隐性梅毒近年来的发病率有显著增长,且在梅毒全部患者中约占50％.此类型梅毒表面以健康状态出现,但大多保留了传染性,并可由潜伏梅毒孕妇胎传致先天梅毒.因此,在术前、孕前及各类体检中筛查隐性、潜伏梅毒患者至关重要,可以防止梅毒进一步传播,特别是先天梅毒的发生.治疗隐性梅毒目前仍首选青霉素,但必须全程、足量、科学、规范,治疗后要定期进行血清学检测,防止复发及抗梅毒不成功现象发生.