苄星青霉素治疗梅毒螺旋体感染相关麻痹性痴呆认知功能障碍的康复疗效  

Effect of benzathine penicillin on recovery of cognitive function of patients with Treponema pallidum infection-associated general paresis of insane

作　　者：杨永秀 丁雯雯 YANG Yong-xiu;DING Wen-wen(Mental Health Center Affiliated to Zhejiang University School of Medicine/Hangzhou Seventh People's Hospital,Hangzhou,Zhejiang 310013,China)

机构地区：[1]浙江大学医学院附属精神卫生中心/杭州市第七人民医院老年精神科,浙江杭州310013

出　　处：《中华医院感染学杂志》2024年第14期2139-2143,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2019RC073)。

摘　　要：目的 分析苄星青霉素维持治疗在梅毒螺旋体(TP)感染相关麻痹性痴呆(GPI)患者认知功能的康复效果.方法 从2021年3月-2022年3月浙江大学医学院附属精神卫生中心收治的感染TP导致的GPI患者中随机抽取69例,按照治疗方案分为A组(33例,青霉素治疗14 d)、B组(36例,青霉素治疗14 d后采用苄星青霉素维持治疗),对比两组效果.结果 B组复发率5.56%比A组更低、治疗6个月简易智能精神状态检查量表(MMSE)评分[时间(3.12±1.34)分、地点(3.15±1.28)分、计算(3.13±1.31)分、重复记忆东西(1.85±0.52)分、总分(18.25±5.37)分]、血清甲苯胺红不加热血清试验(TRUST)滴度(4.85±1.28)log2C-1、临床症状评分[智能降低(4.15±1.12)分、记忆力下降(4.06±1.15)分、人格变化(4.18±1.14)分、行为异常(4.13±1.18)分、思维异常(4.02±1.10)分]、SF-36评分优于A组(P<0.05).结论 感染TP导致的GPI患者青霉素治疗后采用苄星青霉素维持治疗,能更好地改善临床症状和智能水平,降低TRUST滴度水平和复发率效果更加理想,同时能使患者生活质量显著提升.OBJECTIVE To observe the effect of benzathine penicillin on recovery of cognitive function of the pa-tients with Treponema pallidum(TP)infection-associated general paresis of insane(GPI).METHODS A total of 69 patients with TP-induced GPI who were treated in the Mental Health Center Affiliated to Zhejiang University School of Medicine from Mar 2021 to Mar 2022 were randomly recruited as the research subjects and were divided into the group A with 33 cases(treated with penicillin for 14 days)and the group B with 36 cases(treated with benzathine penicillin for maintenance therapy after treatment with penicillin for 14 days)according to the treat-ment plans.The curative effects were observed and compared between the two groups.RESULTS The recurrence rate of the group B was 5.56%,lower than that of the group A.The mini-mental state examination(MMSE)scores[time(3.12±1.34)points,place(3.15±1.28)points,calculation(3.13±1.31)points,repetition memory(1.85±0.52)points,total score(18.25±5.37)points],serum toluidine red unheated serum test(TRUST)titer(4.85±1.28)log2C-1,scores of clinical symptoms[decreased intelligence(4.15±1.12)points,memory decline(4.06±1.15)points,personality change(4.18±1.14)points,behavior abnormality(4.13±1.18)points,abnor-mal thinking(4.02±1.10)points]and SF-36 score of the group B were significantly better than those of the group(P<0.05)after the treatment for 6 months.CONCLUSION The use of benzathine penicillin for maintenance treat-ment of the patients with TP infection-induced GPI after the treatment with penicillin may remarkably improve the clinical symptoms and intelligence,reduce the titer of TRUST and recurrence rate,and remarkably improve the quality of life of the patients.

关 键 词：青霉素 感染梅毒螺旋体 麻痹性痴呆 苄星青霉素 认知功能障碍 康复疗效 临床症状评分 SF-36评分 

分 类 号：R749.1[医药卫生—神经病学与精神病学]