人类免疫缺陷病毒感染对苄星青霉素G治疗的早期梅毒患者血清学反应的影响  

Effect of HIV infection on serological response to benzathine penicillin G in patients with early syphilis

作　　者：许叶文 单海东 王琼 周国儿 XU Yewen;SHAN Haidong;WANG Qiong;ZHOU Guo′er(Department of Pharmacy,Zhoushan Hospital ofTraditional Chinese Medicine,Zhoushan 316000,Zhejiang,China;Department of Dermatology,Zhoushan Hospital of Traditional Chinese Medicine,Zhoushan 316000,Zhejiang,China;Department of Pharmacy,Zhoushan Maternal and Child Health Hospital,Zhoushan 316000,Zhejiang,China)

机构地区：[1]舟山市中医院药剂科,浙江舟山316000 [2]舟山市中医院皮肤科,浙江舟山316000 [3]舟山市妇幼保健医院药剂科,浙江舟山316000

出　　处：《中国性科学》2022年第3期153-157,共5页Chinese Journal of Human Sexuality

摘　　要：目的分析人类免疫缺陷病毒(HIV)感染对苄星青霉素G治疗的早期梅毒患者血清学反应的影响。方法回顾性分析2018年2月至2020年4月舟山市中医院诊治的100例接受苄星青霉素G治疗的男男性行为早期梅毒患者的临床资料,按照是否感染HIV分为HIV阴性组(n=59)和HIV阳性组(n=41)。比较两组血清学反应、T淋巴细胞亚群水平;根据12个月后血清学固定情况分为固定组(n=19)和未固定组(n=81),经单因素、Logistic多因素分析影响血清学固定的相关因素。结果HIV阴性组治疗后9个月的血清有效率比HIV阳性组高,治疗后3、6、9、12个月的血清学治愈率均比HIV阳性组高,治疗后12个月的血清固定率比HIV阳性组低,差异具有统计学意义(P<0.05);HIV阴性组治疗前、治疗后6个月的CD4^(+)、CD4^(+)/CD8^(+)均比HIV阳性组高,CD8^(+)比HIV阳性组低,治疗前后上述指标的差值比HIV阳性组高,差异具有统计学意义(P<0.05);Logistic多因素分析结果发现,HIV阳性、梅毒分期、基线快速血浆反应素试验(RPR)分布均可能是影响血清学固定的危险因素(OR>1,P<0.05)。结论HIV感染可能导致早期梅毒患者T淋巴细胞功能降低,且是苄星青霉素G治疗后血清学固定的独立危险因素;早期梅毒伴HIV感染患者经苄星青霉素G治疗后,其免疫功能改善、RPR转阴获益少于单纯早期梅毒患者。Objective To analyze the effect of human immunodeficiency virus(HIV)infection on the serological response of patients with early syphilis treated with benzathine penicillin G.Methods The clinical data of 100 male patients with early syphilis who received a single dose of benzathine penicillin G in Zhoushan Hospital of Traditional Chinese Medicine from February 2018 to April 2020 were retrospectively analyzed.They were divided into HIV negative group(n=59)and HIV positive group(n=41)according to whether they were infected with HIV.Serological response and T lymphocyte subsets were compared between the two groups.According to the serological fixation after 12 months,they were divided into fixed group(n=19)and unfixed group(n=81).The related factors affecting the serological fixation of patients with early syphilis after benzathine penicillin G treatment were analyzed by univariate and Logistic multivariate analysis.Results The serum effective rate of HIV negative group at 9 months was higher than that of HIV positive group,the serological cure rate at 3,6,9 and 12 months was higher than that of HIV positive group,and the serum fixation rate at 12 months was lower than that of HIV positive group(P<0.05).CD4^(+),CD4^(+)/CD8^(+)in HIV negative group were higher than those in HIV positive group before treatment and 6 months after treatment,and CD8^(+)was lower than that in HIV positive group(P<0.05).The difference of the above indexes before and after treatment in HIV negative group was higher than that in HIV positive group(P<0.05).Logistic multivariate results showed that HIV positive,syphilis stage and baseline rapid plasma reagent(RPR)distribution may be the risk factors affecting serological fixation(OR>1,P<0.05).Conclusions HIV infection may lead to the decrease of T lymphocyte function in patients with early syphilis,which is an independent risk factor for serological fixation after benzathine penicillin G treatment.After treatment with benzathine penicillin G,patients with early syphilis and HIV infection benef

关 键 词：早期梅毒 人类免疫缺陷病毒感染 苄星青霉素G 血清学反应 免疫功能 

分 类 号：R759[医药卫生—皮肤病学与性病学]