广西地区性病门诊人群梅毒的流行病学研究

目的 探讨广西地区性病门诊人群梅毒的流行状况及相关因素。方法 对广西地区8个城市14个性病门诊符合条件的就诊者，由首诊医生进行问卷调查，然后静脉采血，采用甲苯胺红不加热血清试验（TRUST）检测梅毒非特异性抗体，阳性标本则进行梅毒螺旋体明胶凝集试验（TPPA）检测梅毒特异性抗体。流行病学资料采用EpiData数据库收集，SPSS13.0软件进行分析。结果 共有10 930例符合条件入选，其中1297例TRUST和TPPA结果均阳性，患病率为11.9%。女性梅毒患病率为14.3%，男性为10.3%；壮族梅毒患病率为13.3%，汉族为11.4%。与梅毒感染相关的多因素分析发现，女性（OR 2.23，95% CI 1.69 ~ 3.00，P ＜ 0.01）、受教育程度低（初中文化水平，OR 1.70，95% CI 1.11 ~ 2.62，P < 0.05；小学或文盲，OR 1.98，95% CI 1.13 ~ 3.46，P < 0.05）、年收入超过3万（OR 1.91，95% CI 1.18 ~ 3.10，P < 0.01）、提供商业性服务行为或多性伴者（OR 1.54，95% CI 1.16 ~ 2.06，P < 0.01）等因素是性病门诊人群中梅毒感染的危险因素。结论 广西地区性病门诊人群中梅毒常规检测应该增加梅毒血清学项目，同时对高危人群应该加大梅毒流行的干预力度。

Syphilis in outpatients at sexually transmitted disease clinics in Guangxi Zhuang Autonomous Region:an epidemiological study

Objective To investigate the prevalence of syphilis among outpatients in sexually transmitted disease (STD) clinics in Guangxi Zhnang Autonomous Region,and to assess the socioeconomic and behavioral factors associated with the infection.Methods The outpatients to 14 STD clinics in 8 cities of Guangxi Zhnang Autonomous Region were investigated with questionnaires by their doctors at the first visit.Venous blood samples were obtained from these outpatients and subjected to toludine red unheated serum test (TRUST) to screen for syphilis.Treponema pollidum particle agglutination (TPPA) was performed for TRUSTpositive samples.The epidemiological data were collected by using EpiData software,statistically analyzed by using SPSS13.0 software package.Results A total of 10 930 STD outpatients were recruited in the study,and 1297 samples were confirmed to be both TRUST and TPPA positive.The prevalence of syphilis was 11.9％ in all of the outpatients,14.3％ in female outpatients and 10.3％ in male outpatients,13.3％ in the outpatients of Zhuang nationality,and 11.4％ in those of Han nationalily.Multivariate analysis showed that syphilis was independently related to female sex odds ratio (OR) 2.23,95％ confidence interval (CI) 1.69 - 3.00,P＜0.01 ],low educaiion level (middle school:OR 1.70,95％ CI 1.11 - 2.62,P ＜ 0.05; primary school or illiteracy,OR 1.98,95％ CI 1.13 - 3.46,P＜0.05),annual income of more than 30000 Yuan (OR 1.91,95％ CI 1.18 -3.10,P ＜ 0.01 ),commercial sex workers or having multiple sexual partners (OR 1.54,95％ CI 1.16 - 2.06,P ＜0.01 ).Conclusions Syphilis serology should be the routine test in STD clinical settings in Guangxi region,and the intervention should be enhanced to control the prevalence of syphilis in high-risk populations.