不同抗生素对老年晚期潜伏梅毒患者血清RPR滴度及IL-17、IL-23水平的影响  

Effect of Different Antibiotics on Serum RPR Titers and IL-17,IL-23 Levels in Elderly Patients with Late Latent Syphilis

作　　者：闫宁 于晓云 李子海 刘文丽 YAN Ning;YU Xiaoyun;LI Zihai;LIU Wenli(Department of Dermatology,Nanjing Second Hospital/Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing 210003,China;Department of Dermatology,Nanjing Luhe People′s Hospital,Nanjing 211500,China)

机构地区：[1]南京中医药大学附属南京医院(南京市第二医院)皮肤科,南京210003 [2]南京市六合区人民医院皮肤科,南京211500

出　　处：《医学综述》2024年第10期1275-1280,共6页Medical Recapitulate

基　　金：南京市六合区科技计划项目(LHZC2021J10)。

摘　　要：目的探讨不同抗生素对老年晚期潜伏梅毒患者血清快速血浆反应素环状卡片试验(RPR)滴度及白细胞介素(IL)-17、IL-23水平的影响。方法采用抽样便利法选择2021年12月至2022年7月南京中医药大学附属南京医院皮肤科收治的100例老年晚期潜伏梅毒患者为研究对象,按照不同抗生素治疗分为头孢曲松钠组和苄星青霉素组,各50例。头孢曲松钠组给予静脉滴注头孢曲松钠,每次1 g,每日1次,连续治疗10 d;苄星青霉素组给予肌内注射苄星青霉素,每次240万U,每周1次,连续治疗3次。治疗结束后对所有患者进行为期1年的随访。比较两组治疗后6个月、治疗后1年血清RPR滴度转阴情况,同时对比两组治疗前和治疗后1年IL-17、IL-23及免疫功能变化情况,并观察两组治疗期间不良反应发生情况。结果治疗后6个月、治疗后1年,头孢曲松钠组患者血清RPR滴度转阴率均高于苄星青霉素组[28.00%(14/50)比12.00%(6/50)、58.00%(29/50)比38.00%(19/50)](P<0.05)。IL-17、IL-23治疗前后的主效应差异有统计学意义(P<0.01),不考虑测量时间,各指标组间的主效应差异有统计学意义(P<0.05或P<0.01);各指标组间和时点间存在交互作用(P<0.05或P<0.01),治疗后1年,头孢曲松钠组IL-17、IL-23水平低于苄星青霉素组(P<0.05)。CD3^(+)、CD8^(+)、CD4^(+)/CD8^(+)治疗前后的主效应差异有统计学意义(P<0.01),不考虑测量时间,各指标组间的主效应差异有统计学意义(P<0.05);各指标组间和时点间存在交互作用(P<0.05或P<0.01),治疗后1年,头孢曲松钠组CD3^(+)、CD4^(+)/CD8^(+)高于苄星青霉素组,CD8^(+)低于苄星青霉素组(P<0.05)。两组治疗期间腹泻、局部皮疹及不良反应总发生率比较差异均无统计学意义(P>0.05)。结论与苄星青霉素相比,头孢曲松钠治疗老年晚期潜伏梅毒更能提高患者血清RPR滴度转阴率,降低IL-17、IL-23水平,提高免疫功能,且安全性良好。Objective To investigate the effects of different antibiotics on serum rapid plasma reagin ring card test(RPR)titer and levels of interleukin(IL)-17 and IL-23 in elderly patients with late stage latent syphilis.Methods A total of 100 elderly patients with late latent syphilis admitted to Department of Dermatology of Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine from Dec.2021 to Jul.2022 were included by convenience sampling method.According to different antibiotic treatment,they were divided into a ceftriaxone sodium group and a benzathine penicillin group,50 cases in each group.In the ceftriaxone sodium group,intravenous drip of ceftriaxone sodium(1 g each time,once a day,continuous treatment for 10 days)was given,and in the benzathine penicillin group,intramuscular injection of benzathine penicillin(2.4 million U each time,once a week,continuous treatment for 3 times)was given.After treatment,all the patients were followed up for one year.The negative conversion of serum RPR titer was compared between the two groups at 6 months and 1 year after treatment,meanwhile,the changes of IL-17,IL-23 and immune function were compared between the two groups before and 1 year after treatment,and the occurrence of adverse reactions during treatment was observed.Results At 6 months after treatment and 1 year after treatment,serum RPR titers were higher in the ceftriaxone sodium group[28.00%(14/50)vs 12.00%(6/50),58.00%(29/50)vs 38.00%(19/50)](P<0.05).The differences in the main effect of IL-17 and IL-23 before and after treatment were statistically significant(P<0.01),regardless of the measurement time,the main effect difference between different index groups was significant(P<0.05 or P<0.01),and there were interactions between groups and time points of each index(P<0.05 or P<0.01);at 1 year after treatment,IL-17 and IL-23 levels in the ceftriaxone sodium group were lower than in the benzathine penicillin group(P<0.05).The differences in main effects of CD3^(+),CD8^(+)and CD4^(+)/CD8^(+)before and aft

关 键 词：晚期潜伏梅毒 老年患者 血清快速血浆反应素环状卡片试验滴度 白细胞介素-17 白细胞介素-23 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]