系统性红斑狼疮合并潜伏梅毒6例治疗体会  

The Experience of Treatment for 6 Patients of Systemic Lupus Erythematosus Combined with Latent Syphilis

作　　者：刘雪艳[1] 王冰[1] 郑秀芬[1] 钟彩梅[1] 曾抗[1] 孙乐栋[1] 

机构地区：[1]南方医科大学南方医院皮肤科,广东广州510515

出　　处：《中国皮肤性病学杂志》2011年第11期881-882,共2页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨系统性红斑狼疮(SLE)合并潜伏梅毒的临床特点。方法回顾性分析了6例SLE合并潜伏梅毒患者的临床资料。结果 6例患者均为女性,血浆反应素环状卡片试验(RPR)和梅毒螺旋体明胶颗粒凝集试验均阳性。其中4例发现于确诊SLE后3月～1年,2例发生于确诊SLE前。患者均未减少或停用皮质类固醇激素和免疫抑制剂,同时给予头孢曲松0.25g肌肉注射,1次/d,15d为1疗程。2例患者在治疗后1年血清RPR转阴,3例RPR滴度下降4倍以上,后长期稳定在1∶2阳性。1例患者血清RPR滴度呈增高趋势,予苄星青霉素240万U,1次/周,共3次。治疗后患者红斑狼疮病情加重,但血清RPR滴度持续下降。结论 SLE合并潜伏梅毒非常罕见,诊断和治疗较难。头孢曲松可作为较好的替代治疗药物,但需密切观察和随访治疗效果,必要时改用苄星青霉素治疗,并注意有加重SLE病情的可能。Objective To study the clinical characteristics of Systemic＇ l,upus Erythematosus （SLE）combined with latent syphilis. Methods We retrospectively analyzed the clinical materials of 6 SLE patients combined with latent syphilis. Results The 6 patients are all women with rapid plasma reagin test （RPR） and treponema pallidum particle agglutination assay positive. Of whieh ,4 turned positive 3 months - I year after SLE diagnosed and 2 just before it did. All of the patients kept using glucocorticoid and immunosuppressant without decreasing or suspension and were given Ceftriaxone intramuscularly 0.25g once a day for 15 days. After the treatmeant, RPR of 2 patients turned negative, of 3 decreased over 4 times and then maintained positive 1 ： 2. l patient had a increasing RPR and then were given Benzathine penicillin 2.4 million units once per week for 3 times. After the treatment,although she had a decreasing RPR,SLE exacerbations. Conclusions It is rare and hard for diagnosis and treatment for patients with SI^E combined with latent syphilis. Ceftriaxone may be used as a replacement therapy, but more notiee should be given on observations and follow-up. It ean be replaced by Benzathine penicillin sometimes, but also with SLE exacerbations which can not be neglected.

关 键 词：红斑狼疮 系统性 梅毒 诊断 治疗 

分 类 号：R593.241[医药卫生—内科学] R759.11[医药卫生—临床医学]