男男性行为梅毒患者驱梅治疗后血清学变化及影响因素分析  

Analysis of serological changes and influencing factors of men who have sex with men syphilis patients after regular syphilis treatment

作　　者：赵静[1] 石庆[1] 张丽[1] 冯丽 ZHAO Jing;SHI Qing;ZHANG Li;FENG Li(Department of Dermatology,Jingzhou Central Hospital,Jingzhou 434000,Hubei,China;Department of Dermatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)

机构地区：[1]荆州市中心医院皮肤科,湖北荆州434000 [2]华中科技大学同济医学院附属同济医院皮肤科,武汉430030

出　　处：《中国性科学》2021年第5期133-136,共4页Chinese Journal of Human Sexuality

基　　金：2015-2016年度湖北省卫生计生西医类一般项目(WJ2015MB008)。

摘　　要：目的探究男男性行为梅毒患者在正规驱梅治疗后的血清学变化,分析血清固定的危险因素。方法选取2014年3月至2018年3月荆州市中心医院收治的240例男男性行为梅毒患者作为研究对象。按照治疗后TPPA和RPR检测结果,将所有研究对象分为血清固定组和转阴组。所有研究对象匿名填写自制的调查问卷表,并且在治疗前后进行血清学检查。结果 240例患者中,有13例(5.42%)为血清固定,227例(94.58%)显示治疗有效。两组年龄、学历、职业、婚姻状况、同性性角色、异性性行为等基线资料比较,差异无统计学意义(P>0.05);血清固定组晚期梅毒、RPR低滴度、非青霉素治疗的比例明显高于转阴组,差异具有统计学意义(P<0.001);多因素Logistic回归分析结果显示,入院时晚期梅毒、RPR低滴度、非青霉素治疗是驱梅治疗后血清固定的独立危险因素,分别使血清固定的风险增加2.160、1.011、2.175倍。结论男男性行为梅毒患者在正规驱梅治疗后,血清固定的发生率较高。入院时晚期梅毒、RPR低滴度、非青霉素治疗是血清固定的独立危险因素。Objective To explore the serological changes of men who have sex with men(MSM) syphilis patients after regular syphilis treatment, and analyze the risk factors of serum fixation. Methods 240 MSM syphilis patients were selected from Jingzhou Central Hospital from March 2014 to March 2018. According to the results of TPPA and RPR after treatment, all subjects were divided into serum fixation group and negative group. All subjects anonymously filled out self-made questionnaires and underwent serological examinations before and after treatment. Results Of the 240 patients, 13(5.42%) had serum fixation, and 227(94.58%) showed effective treatment. There was no significant difference in baseline data between the two groups, such as age, education background, occupation, marital status, homosexual role and heterosexual behavior(P>0.05). The proportion of late syphilis, low titer of RPR and non-penicillin in serum fixation group was significantly higher than that in the negative group(P<0.001). Multivariate Logistic regression analysis showed that late syphilis on admission, low titer of RPR and non-penicillin treatment were independent risk factors for serum fixation after syphilis treatment, which increased the risk of serum fixation by 2.160, 1.011 and 2.175 times, respectively. Conclusions The incidence of serum fixation was higher in MSM syphilis patients after syphilis treatment. Late syphilis on admission, low titer of RPR, and non-penicillin treatment were independent risk factors for serum fixation.

关 键 词：男男性行为 梅毒 驱梅治疗 血清固定 

分 类 号：R759[医药卫生—皮肤病学与性病学]