我国梅毒临床面临的挑战和机遇  

Syphilis Clinical Challenges and Opportunities Facing Our Country

作　　者：孔杰[1] 刘全忠[1] 

机构地区：[1]天津医科大学总医院皮肤科,天津300021

出　　处：《中国医学文摘（皮肤科学）》2015年第4期329-333,1,共5页China Medical Abstracts(Dermatology)

摘　　要：我国梅毒病人众多,并且发病率逐年递增。这种形势与漏诊问题密切相关。造成漏诊的原因包括:病人就诊率低,梅毒潜伏期较长,隐性梅毒多发,很多病人因不了解自身疾病状态而继续进行性活动;梅毒皮疹表现多样,医生易误诊为其他皮肤病,或迫于紧张的医患关系未做相应化验;现行的化验方法不够合理。此外,对已确诊病人的治疗并不理想,青霉素治疗为首选,但其过敏现象普遍,其他抗生素的疗效并不确定。目前存在很多关于梅毒临床的疑惑,比如神经梅毒的确诊和治疗、潜伏梅毒的传染性及治疗方案、血清固定的处理等。梅毒诊疗的难题也是梅毒临床研究的机遇,有巨大的性病人群,研究条件、设备已不成问题,能在很多方面对梅毒诊治做出更多贡献。疾病防治方面可以借鉴美国治理性病的经验,并结合我国国情,以控制梅毒肆虐。There are numerous syphilitic patients in China and the incidence rate increased year by year. This situation is closely related to missed diagnosis. There are sevsral reasonsof missed diagnosis： rate of visiting the doctor is low,the disease has a long period of incubation and the latent syphilis becomes more prevalent. Ignoring the disease,many patients continue their sexual activity. The rash of syphilis is varied so that some doctors misdiagnose it as other skin diseases. on the other hand,doctors don＇t offer laboratory tests for the patients as the doctor-patient relationship is strained. The algorithm for syphilis serodiagnosis implemented in China is not enough scientific can be another reason for missed diagnosis. In addition,treatment for patients with confirmed syphilis is not completely effective. Penicillin is the first selection but allergy can occur easily.The curative effects of other antibiotics are not clear. There is a lot of confusion about syphilis such as diagnosis and treatment of neurosyphilis,infectivity and therapy about latent syphilis and how to deal with sero-resistance. These challenges are also our clinical research opportunities. By abundant patient resource,favorable research conditions and equipments,we could make more contribution to the diagnosis and treatment of syphilis. We can learn the experience of America and combine with Chinese national condition to prevent and control syphilis.

关 键 词：梅毒 挑战 机遇 

分 类 号：R135.7[医药卫生—劳动卫生] R759.1[医药卫生—公共卫生与预防医学]