苄星青霉素联合多西环素在早期梅毒治疗中的应用  

Application of benzathine benzylpenicillin combined with doxycycline in treatment of early syphilis

作　　者：李孝辉 张晓彬[1] 刘浩 徐继鹏[1] 姜其学[1] 刘磊[1] LI Xiao-hui;ZHANG Xiao-bin;LIU Hao;XU Ji-peng;JIANG Qi-xue;LIU Lei(Department of Dermatology,the Affiliated Hospital of Xinyang Vocational and Technical College,Xinyang,Henan 464000,China)

机构地区：[1]信阳职业技术学院附属医院皮肤科,河南信阳日464000

出　　处：《医药论坛杂志》2025年第5期535-538,共4页Journal of Medical Forum

摘　　要：目的探讨苄星青霉素联合多西环素在早期梅毒治疗中的应用效果。方法回顾性分析信阳职业技术学院附属医院皮肤科2020年10月—2023年1月收治的98例早期梅毒患者临床资料,根据治疗方案不同分为对照组(采用苄星青霉素治疗,n=51)和研究组(采用苄星青霉素联合多西环素治疗,n=47),患者均完成3周治疗。比较两组治疗前后体液免疫指标[免疫球蛋白(immunoglobulin,Ig)A、IgG、IgM]和细胞免疫指标[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)];观察两组药物不良反应;治疗结束后随访12个月,统计两组治疗后3个月、6个月、12个月的甲苯胺红不加热血清试验(oluidine red unheated serum test,TRUST)转阴率。结果治疗后,两组IgA、IgG、IgM有所降低,且研究组更低(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)有所升高,且研究组更高,两组CD8^(+)降低,且研究组更低(P<0.05)。治疗后12个月,研究组TRUST转阴率[91.49%(43/47)]高于对照组[76.47%(39/51)](P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论苄星青霉素联合多西环素可改善早期梅毒患者免疫功能,提高TRUST转阴率,且安全性好。Objective To explore the application effect of benzathine benzylpenicillin combined with doxycycline in the treatment of early syphilis.Methods The clinical data of 98 patients with early syphilis admitted to the Dermatology Department of the Affiliated Hospital of Xinyang Vocational and Technical College from October 2020 to January 2023 were retrospectively analyzed.According to different treatment regimens,they were divided into control group(treated with benzathine benzylpenicillin,n=51)and study group(treated with benzathine benzylpenicillin combined with doxy-cycline,n=47).All patients completed 3 weeks of treatment.The humoral immune indexes[immunoglobulin(Ig)A,IgG,IgM]and cellular immune indexes[CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]were compared between the two groups before and after treatment.The adverse drug reactions of the two groups were observed.The negative conversion rate of toluidine red unheated serum test(TRUST)at 3 months,6 months and 12 months after treatment was measured in the two groups.Results After treatment,the levels of IgA,IgG,and IgM in both groups decreased,and the study group had lower levels(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups increased,and those in the study group were higher.The levels of CD8^(+)in the two groups decreased,and those in the study group were lower(P<0.05).After 12 months of treatment,the TRUST conversion rate in the study group[91.49%(43/47)]was higher than that in the control group[76.47%(39/51)](P<0.05).There was no statistical significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Benza-thine benzylpenicillin combined with doxycycline can improve the immune function of early syphilis patients,increase the negative conversion rate of TRUST,and have good safety.

关 键 词：梅毒 早期 苄星青霉素 多西环素 免疫 甲苯胺红不加热血清试验 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]