重庆铁路辖区内48例老年男性性传播疾病混合感染临床分析

目的了解重庆铁路辖区内离退休老年(≥60岁)男性性传播疾病(STD)混合感染者的临床特征,分析影响老年男性STD混合感染的相关因素,为辖区内老年男性STD的防治提供参考依据。方法对2009～2012年间在重庆市第十三人民医院皮肤性病科门诊就诊的432例老年(≥60岁)男性STD患者进行检测,将检测到的48例混合感染作为调查研究对象,制作老年STD混合感染的流行病学及临床调查表,依据患者病原体检测、问诊查体、治疗预后以及睾酮水平检测等方面的结果填写相关项目。结果 432例老年男性STD患者检测病原体,48例为混合感染,占11.1%。老年男性STD混合感染有6种病原体:沙眼衣原体、淋病奈瑟菌、梅毒螺旋体、人类免疫缺陷病毒、人类乳头瘤病毒及疑似杜克雷嗜血杆菌;有10种组合模式,以沙眼衣原体加人类乳头瘤病毒和淋病奈瑟菌加人类乳头瘤病毒混合感染最为常见,分别占27.1%和20.8%;首诊症候群首位为阴部疣状物加尿路症状(28例),其次为阴部丘疹破溃加尿路症状(6例)。采用最优的综合治疗后1个月仅治愈6例,2个月治愈7例,3个月治愈11例,治愈率为50%;血清睾酮水平:观察组为(14.7±5.8)mmol/L,健康对照组为(10.3±5.6)mmol/L,观察组血清睾酮水平高于对照组,两组比较差异有统计学意义(t=3.41,P<0.05)。结论老年人群STD混合感染并不少见。治疗疗程长、疗效低及婚外性行为、较高的血清睾酮水平是导致老年STD及混合感染发生的主要原因。

Clinical analysis of 48 elderly male sexually transmitted diseases mixed infections in the area of Chongqing railway

Objective To understand clinical features of sexually transmitted diseases（STD） mixed infection among retired and elderly（≥60 years old）males in the area of Chongqing railway and analyze relevant factors to provide a reference for the prevention and treatment.Methods 432 elderly male patients in Outpatient Departments of Kin and Venereal Disease in the 13th People′s Hospital of Chongqing City from 2009-2012 were detected,48 cases of mixed infections were detected and as research objects.The epidemiology and clinical questionnaire for elderly STD mixed infection were made.Items were filled based on pathogen detection,inquiry body,treatment prognosis and testosterone levels.Results Pathogens of 432 elderly male STD were detected,and 48 cases were mixed infections,accounting for 11.1%.Elderly male STD mixed infection had 6 types of pathogens：chlamydia trachomatis,neisseria gonorrhoeae,treponema pallidum,human immunodeficiency virus,human popilloma virus,suspected haemophilus ducreyi,with 10 kinds of combination modes,most of which were mixed infection of chlamydia trachomatis and human popilloma virus,neisseria gonorrhoeae and human popilloma virus,accounting for 27.15% and 20.8% respectively.The first diagnosis of syndrome was genital ware like and urinary symptoms（28 cases）,followed by pudenda popular ruptured and urinary symptoms（6 cases）.6 cases were cured after 1 month of optimal comprehensive treatment,7 cases were cured after 2 months,11 cases were cured after 3 months,and the cure rate was 50%.Serum testosterone level of observation group was（14.7±5.8）mmol/L,that of healthy control group was（10.3±5.1）mmol/L,and serum testosterone level of observation groups was significantiy higher than healthy control group（t= 3.41,P0.05）.Conclusion Elderly STD mixed inflections might not be uncommon.Longer treatment regimens,lower curative effect,sex outside marriage and high levels of serum testosterone could be the main reasons.