早期显性梅毒治疗的预后研究

目的：探索影响早期显性梅毒预后的因素。方法：用前瞻性研究的方法对202例早期显性梅毒的预后因素进行分析。结果：患者的年龄、病程、梅毒的分期、伴有的系统疾患、神经系统症状与梅毒的预后呈负相关。采用四环素、红霉素、多西环素等药物治疗的患者，其预后明显差于用头孢曲松或青霉素治疗的患者。治疗结束后3个月血清快速血浆反应素试验(RPR)滴度下降2个滴定值或以上，6个月RPR滴度下降4个滴定值或以上与梅毒的预后呈正相关。多元回归分析显示：治疗药物、梅毒的分期及病程是影响梅毒预后的主要因素。结论：一期梅毒经正规治疗后随访期1年即可。治疗结束后3个月RPR滴度下降2个滴定值或以上，6个月RPR滴度下降4个滴定值或以上，可作为短期内决定是否进行重复治疗的指标。

Study on the prognosis of early symptomatic syphilis

Objective: To understand the prognosis of syphilis. Methods: Data on 202 cases of early-stage syphilis were analyzed by a prospective study. Results: Single variate analysis indicated the prognosis was negatively correlated with age, clinical course, stage of syphilis and systemic involvement. The prognosis in the patients treated with penicillin or ceftriaxone was better than those with tetracycline, erythromycin and doxycycline. After the treatment it was also positively correlated with the decrease of RPR titer. Multivariate regression analysis indicated that the medicine, stage of syphilis, and clinical course were significant factors influencing prognosis of syphilis. Conclusions: A one-year duration of follow-up for most primary syphilis might be adequate. The decrease of RPR titer after treatment could be served as an indicator of repeat treatment in a short term.