梅毒患者吉海反应研究进展  

The Study of Jarisch-Herxheimer Reaction in Patients with Syphilis

作　　者：严红萍 王燕婷 程燕春 张怀健 YAN Hongping;WANG Yanting;CHEN Yanchun;ZHANG Huaijian(Shanghai Skin Disease Hospital,Shanghai 200000,China)

机构地区：[1]上海市皮肤病医院,上海200000

出　　处：《中国皮肤性病学杂志》2020年第11期1337-1340,共4页The Chinese Journal of Dermatovenereology

摘　　要：梅毒患者在抗生素治疗2~5 h后可能发生吉海反应,其主要表现为发热、寒战、头痛、肌痛和皮疹加重等,一般在24 h内消退,但各期梅毒发生吉海反应的临床表现也不完全相同。各期梅毒患者均有可能发生吉海反应,但血RPR滴度高、早期梅毒、青霉素治疗和梅毒合并HIV感染者中吉海反应发生率更高。吉海反应的病理机制目前还不完全清楚,可能与炎症因子的过度表达、补体系统的激活和单核细胞的吞噬等有关。吉海反应的预防和治疗方案并不明确,主要以尽早发现和对症治疗为主。Jarisch-Herxheimer reaction might occurre in patients with syphilis at 2~5 hours after the first antibiotic treatment.The main manifestations were fever,chills,headache,myalgia and rash aggravation and so on and disappeared within 24 hours.The manifestations of Jarisch-Herxheimer reaction displayed in different stages of syphilis.Jarisch-Herxheimer reaction might occur in all stages of syphilis,but the incidence was higher in patients with high blood RPR titers,early syphilis,penicillin treatment and syphilis co-infected with HIV.The pathological mechanisms of Jarisch-Herxheimer reaction were not fully understood,which might be related to overexpression of inflammatory cytokines,activation of complement system and phagocytosis of monocytes.The prevention and treatment of Jarisch-Herxheimer reaction was unclear.Support therapy and early diagnosis were the main method.

关 键 词：梅毒 吉海反应 临床表现 危险因素 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]