早期梅毒38例临床分析

目的：探讨早期梅毒发病的特点,提高对梅毒的认识,以减少误诊.方法：对38例早期梅毒患者的临床资料进行回顾性分析.结果：38例梅毒患者男女比例为1∶ 1.92,年龄主要集中在21～40岁,传播途径以卖淫嫖娼及其他非婚性接触为主.一期梅毒9例（23.68%）,主要表现为生殖器部位的硬下疳;二期梅毒29例（76.31%）,以掌跖梅毒疹、扁平湿疣、斑疹样皮损为主.其中5例被误诊,误诊率为13.16%.结论：早期梅毒临床表现多种多样,为减少误诊,漏诊,提高对早期梅毒临床皮肤损害的认识,并对高危人群的梅毒血清学筛查是非常必要的.     

355例早期梅毒流行病学及临床特点分析

目的了解贵州省凯里市早期梅毒流行病学特征及临床特点,为临床早期诊断及治疗提供依据。方法对2007年1月—2013年12月355例早期梅毒患者的临床资料进行统计学分析。结果高发年龄(20~39)岁66.76%,一期梅毒比例15.21%,二期梅毒比例29.86%,先天梅毒比例0.8%,潜伏梅毒比例54.93%,传染源主要为非婚性接触。结论凯里市梅毒传播的主要途径非婚性接触,提示应加强性教育,普及性防知识,非婚男女青年做梅毒血清学筛查是非常必要的。     

深圳市1984年～2003年梅毒流行病学分析

目的:通过对深圳市20年梅毒的流行特征进行分析,探讨该市近年来梅毒发病率大幅增长的因素,为今后的防治工作提供科学依据.方法:收集整理该地区系统的梅毒疫情资料并进行流行病学分析.结果:20年来深圳市梅毒的发病率呈上升趋势.以早期梅毒为主,二期梅毒报病数高于一期梅毒;职业构成以工人、饮服人员、无业、干职及个体从业者为主;梅毒患者中已婚者占大多数;传染来源以非婚性接触为主.结论:根据深圳市梅毒的流行病学特征,应采取有针对性的预防措施,从而有效地控制梅毒的流行.     

51例梅毒患者临床治疗体会

本文介绍近 4年来我科应用不同药物治疗 5 1例早期梅毒患者的临床体会。临床资料　本组共 5 1例梅毒患者 ,其中男 31例 ,女 2 0例。年龄 2 0～ 6 0岁 ,其中 2 0～ 40岁 48例 (94.1%)。本组病例均具有早期梅毒皮肤粘膜损害。临床分期 :(1)一期梅毒 19例 (37.3%) ;(2 )二期梅毒 3     

107例II期梅毒患者皮疹类型分析

1999年 10月～ 2 0 0 2年 2月经我科确诊的ＩＩ期梅毒患者 10 7例 ,现报告如下。临床资料　本组 10 7例ＩＩ期梅毒患者 ,均按卫生部颁发的梅毒诊断标准确诊 ,病期分别为数天至 10个月不等 ,其中男 36例 ,女 71例 ,男女之比为 1:1.94 ,年龄最小的 18岁 ,最大的 6 5岁 ,承认有非婚性接触史的 88例 ,16例为配偶间感染 ,余 3例病史不详。临床表现主要为扁平湿疣、掌跖红斑、玫瑰糠疹样疹、斑疹 ,见表 1、2。讨论　单一扁平湿疣 2 8例 ,合并其它皮疹的 9例 ,计 37例 ,占病例总数的 35 % ,掌跖脱屑性暗红斑 4 5例 ,占总数的 4 2 % ,与李世泰统计的…     

33例早期梅毒患者临床分析

我们于 1990年 10月在门诊发现第一例早期梅毒患者后 ,至 1999年 6月共遇到 33例梅毒患者 ,全部为后天梅毒 ,病期均在 2年以内。现将有关情况分析如下。临床资料　 33例患者中 ,男 19例 ,女14例 ,年龄 2 0～ 6 4岁 ,平均 36 .0岁 ,已婚2 7例 ,未婚 6例 (其中怀孕 6个月 1例 ) ;厂矿企业供销人员 14例 ,个体户主 6例 ,汽车司机 5例 ,农民 (包括民工 ) 3例 ,女性服务员 5例 ;非婚性接触 2 4例 ,夫妻传播 6例 ,冶游史不明 3例。临床表现　一期梅毒和二期梅毒患者分别为 18例和 15例。在 18例一期梅毒者中 ,男性 15例、女性 3例 ,男女之比为 5 :…     

2003-2005年广东省佛山市南海区梅毒流行病学分析

目的:通过对佛山市南海区2003-2005年梅毒的流行特征进行分析,探讨该区近年来梅毒发病率大幅增长的因素,为今后的防治工作提供科学依据。方法:收集整理该地区系统的梅毒疫情资料并进行流行病学分析。结果:3年来南海区梅毒的发病率呈上升趋势。以早期梅毒为主,胎传梅毒和隐性梅毒呈逐年增长趋势;职业构成以工人、农民、无(待)业、个体、饮服为主;梅毒患者中已婚者占大多数;传染来源以非婚性接触为主。结论:根据南海区梅毒的流行病学特征,应采取有针对性的预防措施,从而有效地控制梅毒的流行。     

深圳市南山区1994～2006年梅毒流行病学分析

目的探讨深圳市南山区1994～2006年梅毒流行病学特征,为进一步制定预防控制措施提供科学依据。方法对1994～2006年南山区梅毒疫情资料及人口数据进行统计分析。结果南山区梅毒发病率从1994年的0.75/l0万增至2006年的43.41/10万,年均递增77.58%;梅毒在8种上报性病中的构成比年均递增101.83%;梅毒患者以早期为主,二期梅毒报病数高于一期梅毒;一期梅毒以男性为多,隐性梅毒以女性为多;发病年龄主要集中在20～29岁,职业以工人为主,文化程度以中学为多;传染来源主要是非婚性接触,占72.10%。结论南山区梅毒流行经历了低流行高增长期后,目前进入高流行低增长期。根据其特点,应采取在全社会加强性病防治知识宣教、提倡安全性行为、加强重点人群监测及规范诊治等综合措施,以控制梅毒的流行。     

7221例梅毒流行病学分析及防治对策的初步探讨

目的:分析泉州地区梅毒流行的特征,为今后防治工作提供科学依据.方法:用全国性病计算机管理系统软件汇总分析泉州市1991年～2002年的性病疫情年度报表.结果:1991年～1994年为散发,从1995年至2002年开始出现流行态势;病期以早期(一、二期)梅毒为主,占74.58%;患者的文化程度以中学及以下为多,占94%;职业分布以无业、农民、饮服业、工人、个体为多;性别比例为男女之比为1∶1;年龄主要集中于20～39岁;已婚占47.42%;传染方式66%为非婚性接触.结论:本地区梅毒发病率已形成流行态势,同全国流行趋势一致.因此,应加强性病防治知识的宣传教育,提倡安全性行为,加强对高危人群的监测,规范梅毒的诊治等综合措施,以便能有效地控制梅毒的流行.     

二期梅毒鼻部损害四例北大核心CSCD

梅毒是一种常见的性传播疾病.二期梅毒的鼻部损害少见,它起病隐匿,患者常隐瞒病史,易被误诊.现将2002年5月至2010年3月,本院诊治的伴鼻部损害的二期梅毒4例报道如下.一、临床资料4例均为本院门诊患者,男3例,女1例,年龄28～67岁,均有非婚性接触史.病程4～ 12周,均以鼻部浸润斑块、结节为主诉就诊,2例伴鼻塞,2例伴咽痛.2例就诊前2～3周发生外生殖器溃疡,2例否认外生殖器溃疡史.     

123例早期梅毒临床分析

目的观察早期梅毒的临床特点及疗效,为提高早期诊治水平提供科学依据。方法对123例早期梅毒患者的临床资料进行综合分析。结果本组病例中男性76例,女性47例。Ⅰ期梅毒53例,以外生殖器硬下疳为主;Ⅱ期梅毒67例,以掌跖暗红斑、扁平湿疣及玫瑰疹为主;潜伏梅毒3例,无皮疹。123例患者USR、Trust、TI'PA试验均为阳性(100%):使用苄星青霉素治疗梅毒血清试验阴转率达95.9%。结论早期梅毒临床表现多样性,易误诊。苄星青霉素是治疗早期梅毒的首选药物。     

181例隐性梅毒临床特征分析

目的：对181例隐性梅毒患者临床特征进行统计分析.方法：对2011年3月至2012年2月期间在我院确诊的181例隐性梅毒患者的临床资料进行回顾性分析.结果：181例隐性梅毒患者,其中男117例,女64例;男女比例为1.828：1.30～ 40岁年龄段隐性梅毒感染率最高,为30.39％,其次为20～30岁,为20.44％,20岁以下年龄较小的人群隐性梅毒感染率最低,为3.31％.非婚性接触为梅毒感染的主要途径.49.7％患者存在非婚异性性接触史.初中文化程度的患者感染率最高（33.1％）,初中及以下者占大部分.已婚人群梅毒感染率高于未婚、离异者.相当部分患者合并其他性病.结论：隐性梅毒是重要传染源,因此对其进行早期检查、早期发现、早期治疗对控制梅毒感染意义重大.     

Clinical manifestations of early syphilis by HIV status and gender: results of the syphilis and HIV study

BACKGROUND: Despite reports of unusual clinical presentations and therapeutic responses among HIV-infected patients with syphilis, syphilis has not been regarded as a serious opportunistic infection that predictably progresses among most HIV-coinfected patients. GOAL: To define and describe differences in the presentation and response to treatment of early syphilis among HIV-infected and HIV-uninfected patients, to describe any differences by gender, and to determine if clinical presentation of central nervous system involvement predicted serologic failure. DESIGN: A prospective, multicenter, randomized, controlled trial of enhanced versus standard therapy to compare the benefit of enhanced therapy, the clinical importance of central nervous system involvement, and the clinical manifestations of early syphilis infection among HIV-infected and HIV-uninfected patients. RESULTS: The median number of ulcers was significantly greater among HIV-infected and HIV-uninfected patients, as was the percent of HIV-infected patients with multiple ulcers. Among patients diagnosed with secondary syphilis, a higher percentage of HIV-infected patients presented with genital ulcers [13/53 (25%)] than did HIV-uninfected patients [27/200 (14%)]. No differences between HIV-infected and HIV-uninfected patients were detected for other secondary syphilis manifestations. Although women presented more frequently with secondary syphilis than did men, no other gender differences in clinical manifestations were noted. Neurologic complaints were reported most frequently among patients with secondary syphilis [103/248 patients (42%)] compared with patients with primary syphilis [32/136 (24%)] and early latent syphilis [48/ 142, (34%)] (P < 0.05), but no differences in neurologic complaints were apparent by HIV status or CSF abnormalities. No neurologic complaints were significantly associated with serologic treatment failures at 6 months. CONCLUSIONS: Overall, HIV infection had a small effect on the clinical manifestations of primary and secondary syphilis. Compared with HIV-uninfected patients, HIV-infected patients with primary syphilis tended to present more frequently with multiple ulcers, and HIV-infected patients with secondary syphilis presented with concomitant genitals ulcers more frequently.     

以带状疱疹为首发症状的艾滋病8例临床分析

目的探讨合并有性病、多种皮肤病、嫖娼、多性伴史与以带状疱疹为首发表现的艾滋病患者的特点和关系。方法对2011年3月-2012年2月间诊治的8例以带状疱疹为首发表现的艾滋病患者临床资料进行分析。结果 8例患者中男3例,女5例,年龄26～38岁7例,81岁1例;未婚和丧偶5例,在婚3例。8例一般情况良好,带状疱疹于躯干四肢7例,额面部1例。皮损为大面积群簇性水疱、大疱、血疱,部分融合伴剧烈刺痛。合并非淋菌性尿道(宫颈)炎2例,淋病1例,尖锐湿疣1例,隐性梅毒1例,合并复发性生殖器疱疹和进展期肺结核1例。同时合并单纯疱疹、脂溢性皮炎1例;同时合并尖锐湿疣、非淋菌性宫颈炎及隐性梅毒1例。8例患者有多性伴或嫖娼史,无输血史、吸毒史,经过治疗后7例治愈,1例后遗神经痛3个月。结论对于带状疱疹患者,文化程度较低、不在婚者、有多性伴史、嫖娼史、过去和现时有性病史者,或多种反复发作的皮肤病、肺结核,特别是服务行业年轻女性、性活跃者,都应行HIV初筛检查,以免漏诊。     

Early diffuse alopecia in a neonate with congenital syphilis

Neonatal alopecia has been described in many circumstances but never as a part of the constellation of signs in congenital syphilis. Common clinical features of early congenital syphilis include hepatosplenomegaly, skeletal deformities, hematologic disturbances, and mucocutaneous features such as rhinitis and maculopapular rash. Syphilitic alopecia has previously been described only in conjunction with secondary syphilis. In this article, we describe the first occurrence of alopecia in a neonate with congenital syphilis.     

1990年全国38个城市监测点梅毒流行病学调查报告

总给了1990年全国24个省(市)38个性病监测点梅毒流行病学调查资料.一年中,总计发现梅毒病人809例.平均年发病率为0.75/10万人、男性发病率(0.97/10万)明显高于女性(0.52/10万),新祖、陕西、甘肃和河北等省区的发病率较其他省区为高.本组梅毒病人多为性活跃年龄者,20-39岁年龄组患者占73.54%.对性和性行为的态度有明显改变.患者中初中以下文化程度占71.32%.早期梅毒占97.21%(787例),三期梅毒1.65%(l3例),先天梅毒1.14%(9例).     

Primary and secondary syphilis, 20 years'' experience. 2. Clinical features.

The notes of 946 patients with primary and 854 with secondary syphilis were retrospectively reviewed. Of the 184 heterosexual men with primary syphilis, 182 (99%) had chancres affecting the penis, compared with 467 (64%) of the 728 homosexual men (p less than 0.0001). Anorectal chancres occurred in 249 (34%) of homosexual men. The commonest features of secondary syphilis included a rash, lymphadenopathy, and mucous patches of the mouth or genital area. Hepatitis, meningitis, other neurological problems, iridocyclitis, and periostitis were all exceptionally rare. The clinical features of primary and secondary syphilis do not appear to have changed in recent years.     

Factors and the sociosexual network associated with a syphilis outbreak in rural North Carolina

OBJECTIVE: An investigation was conducted to determine factors associated with a syphilis outbreak in a rural North Carolina county. STUDY DESIGN: A retrospective chart review was performed on 61 primary (PS), secondary (SS), and early latent (ELS) syphilis case patients reported in Columbus County between January 2001 and February 2002. Sociosexual network analysis was conducted using electronic contact tracing information. RESULTS: We identified 20 PS, 25 SS, and 16 ELS case patients who were predominantly black. Seventy-two percent had reported >or=1 sexual partner with early syphilis, 51% used crack cocaine and/or had sex with a crack-using partner, and 31% exchanged sex for drugs or money. The sexual network exhibited predominantly linear connections between case patients and sexual partners. Adding social connections to the network further demonstrated dense cyclic interactions characteristic of core groups. CONCLUSIONS: The syphilis outbreak in this rural community was associated with crack cocaine and exchange of sex for drugs in a densely interconnected sociosexual network.     

妊娠合并梅毒临床病例分析

目的：总结妊娠合并梅毒病例的临床特点及产前梅毒筛查情况，研究梅毒治疗时间对妊娠结果的影响。方法：对我院1998年4月—2002年4月间妊娠合并梅毒的病例进行回顾性分析。结果：妊娠合并梅毒病例30例，占住院分娩病例总数的0．49％。潜伏梅毒病25例，占83．3％；Ⅰ期梅毒、Ⅱ期梅毒及妊娠前驱梅治疗后血清固定的病例各占3．3％、6．7％、6．7％。晚期妊娠发现梅毒病例中，死胎或畸胎6例，先天性梅毒婴儿3例，远多于妊娠早期及中期发现梅毒的病例。结论：妊娠合并梅毒病例的临床表现以潜伏梅毒为主。治疗梅毒的时间对妊娠结局有一定影响。     

The use of immunoenzyme analysis for recording specific IgM antibodies in syphilis patients

Specific IgM antibodies were assayed in blood sera of 230 patients with various forms of syphilis and of 561 controls. Enzyme immunoassay (EIA) sensitivity has made up 95.8 percent for primary syphilis, 93.8 percent for secondary new, 78.3 percent for secondary recurrent, 35.4 percent for early latent, 37.5 percent for late latent, and 80 percent for unknown syphilis. False-positive reactions were recorded in 5.5 percent of cases and were as a rule seen in the sera from patients with diffuse diseases of connective tissue. IgM EIA has proved highly effective in testing the sera from patients with primary seronegative syphilis and from subjects who had sexual intercourse with patients suffering from contagious forms of syphilis.