梅毒血清抵抗发生率及其相关因素

目的 回顾性分析梅毒血清抵抗的发生率及其相关因素.方法 选择131例确诊梅毒患者,分析梅毒血清抵抗的发生率以及血清抵抗与年龄、性别、快速血浆反应素环状卡片试验(RPR)初始滴度、疾病分期、治疗用药等因素的关系.结果 不同年龄、性别患者间梅毒血清抵抗的发生率差异无显著性.不同初始滴度、疾病分期和治疗用药间差异均有显著性(P<0.01).RPR初始滴度较低患者血清抵抗发生率较高,其中滴度为1∶8患者抵抗发生率高达61%.潜伏梅毒患者血清抵抗发生率高达45.6%,而一期梅毒血清患者仅为10%.苄星青霉素治疗后血清抵抗发生率仅为28.3%,而大环内酯类为72.7%.结论 初始滴度较低、潜伏梅毒及应用大环内酯类药物治疗的梅毒患者较易发生血清抵抗.

Incidence of seroresistance of syphilis and its relevant factors

OBJECTIVE: To investigate the incidence of seroresistance of syphilis and analyze its relevant factors. METHODS: The clinical data of 131 patients with syphilis were retrospectively analyzed. The incidence of seroresistance was investigated and the correlation between seroresistance and factors including age, gender, original titer, disease course, and medications were analyzed. RESULTS: The incidence of seroresistance was not significantly different among patients with different ages and genders, but was significantly different among patients with different disease courses, antibody titers, and medications. Patients with a baseline serum rapid plasma reagin (RPR) titer of greater than 1: 8, a latent course, or a macrolide therapy history had higher incidences of seroresistance (i. e., 61%, 45.6%, and 72.7% respectively) than those who had a lower RPR titer, a primary course, or a benzathine penicillin therapy history. CONCLUSION: Syphilis patients with a high baseline RPR titer, a latent course, and a macrolides therapy are prone to be seroresistant.