老年梅毒患者185例临床特征和治疗后的血清学转归  

Clinical Characteristics of 185 Elderly Patients with Syphilis and Serological Response After Treatment

作　　者：王俊兴[1] 郝树媛[2] 陈丽芳[2] WANG Junxing;HAO Shuyuan;CHEN Lifang(Department of Dermatology,Sixth Division Hospital of Xinjiang Production and Construction Corps,Wujiaqu 831399,China;Department of Dermatology,Shanxi Province People's Hospital,Taiyuan 030012,China)

机构地区：[1]新疆生产建设兵团第六师医院皮肤科,新疆五家渠831399 [2]山西省人民医院皮肤性病科,山西太原030012

出　　处：《中国皮肤性病学杂志》2021年第4期430-434,共5页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨山西地区老年梅毒患者的临床特征及血清学转归特点。方法回顾性分析426例成年梅毒患者的临床资料,分为老年组(≥60岁)和对照组(<60岁),分析两组间的一般资料、临床分期及血清滴度的差异,比较治疗结局、不同血清滴度及临床分期的血清学转归。结果老年组185例,对照组241例。老年组中66.49%(123/185)为男性患者,72.97%为初中以下学历,农民或民工占42.70%,两组比较差异有统计学意义(P<0.01);52.43%的老年患者因术前和住院筛查确诊,高于对照组的31.95%;23.24%因皮疹或系统损害就诊,低于对照组的53.11%;非婚性接触是主要传染途径,占48.11%,低于对照组的65.56%;22.16%因配偶传染,高于对照组的14.94%,差异有统计学意义(P<0.01)。临床特征中老年组40.54%为潜伏梅毒,对照组二期梅毒占47.30%。近1/2的老年患者血清滴度范围集中在1:1~1:4,对照组中2/5的患者血清滴度在1:8~1:32,差异有统计学意义(P<0.01)。老年组治疗有效率为50.27%,低于对照组的71.78%,血清固定率为40%高于对照组的21.58%,差异有统计学意义(P<0.01);其中1:1~1:4血清滴度组及潜伏梅毒组的治疗有效率低于对照组(31.52%vs.50.72%,P=0.015;26.67%vs.52.83%,P=0.003)。结论老年梅毒患者具有低学历、被动就诊、非婚性接触、临床特征以潜伏梅毒和低血清滴度为主的特点。潜伏梅毒及低血清滴度组治疗有效率低。因此要加强老年人性健康教育,提高主动进行性病监测的意识,改善治疗结局。Objective To investigate the clinical feature and serological outcome in the elderly patients with syphilis.Methods In this study,426 adult patients were divided into≥60 years of age group(185 cases)and control group(<60 years of age,241 cases).We analyzed the differences in general data,clinical stages and serum titer and compared retrospectively the treatment outcome,serological response between the two groups.Results Among the elderly group,66.49%were male patients,72.97%were educated under senior high school,and 42.70%were peasants or migrant workers.The difference between the two groups was statistically significant(P<0.01).To be more percisely,52.43%elderly patients were confirmed by preoperative examination and hospital screening,higher than the control group(31.95%);23.24%patients were treated for skin rash or organ damage,lower than 53.11%of the control group(P<0.01).Non-marital contact was the main route of infection,accounting for 48.11%,but less than the control group(65.56%);22.16%were infected by spouse,up from 14.94%in the control group.Among the clinical features,40.54%of the elderly group was latent syphilis,and 47.30%of the control group was secondary syphilis.The serum titer of nearly half elderly patients was 1:1 to 1:4,and two fifths of the control group was 1:8 to 1:32,the difference was statistically significant(P<0.01).The total effective rate after treatment was 50.27%,lower than 71.78%of the control group,serum fixed rate was 40%,higher than the control group(21.58%),(P<0.01).The therapeutic efficiency of serum titer group in the range of 1:1~1:4 and latent syphilis group was lower than that of the control group(31.52%vs.50.72%,P=0.015;26.67%vs.52.83%,P=0.003).Conclusion The characteristics of the elderly patients with syphilis are low education,passive medical treatment,non-marital contact,and the primary clinical features are latent syphilis and low serum titer.The effective rate of latent syphilis and the group of low serum titer is low.Therefore,it is necessary to strengthen sexual

关 键 词：梅毒 老年人 血清学 转归 治疗结果 回顾性分析 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]