梅毒患者治疗后血清学转归的影响因素探讨

目的探讨影响梅毒治疗后血清转归的相关因素。方法回顾性研究226例HIV阴性梅毒患者的临床资料，观察驱梅治疗1年后血清痊愈或血清固定发生的情况，对影响血清固定的患者年龄、病期、性别、快速血浆反应素环状卡片试验（RPR）初始滴度、治疗用药等因素进行多因素Logistic分析。结果226例患者中，154例（68．1％）血清痊愈，72例（31．9％）发生血清固定，随着病期延长，血清固定发生率增加。多因素Logistic分析结果显示，驱梅治疗后发生血清固定的因素包括：女性患者（OR=2．517，95％CI：1．159～5．464）、初始RPR滴度≤1：16（OR=4．370，95％C1：1．311-14．562）和非苄星青霉素治疗（OR=4．959，95％CI：1．650-14．901），而与血清学痊愈相关的临床特征包括：一期梅毒和二期梅毒患者和年轻患者（≤25岁）（均P〈0．05）。结论梅毒治疗后血清学痊愈或固定与患者病期、性别、年龄、RPR基线滴度、治疗药物有关。

Analysis of factors predicting serological response in patients after syphilis treatment

Objective To identify factors predicting serological response in patients after syphilis treatment. Methods A retrospective study was performed on 226 human immunodeficiency virus （HIV）- negative patients with syphilis. Serological response was evaluated in these patients within one year after regular treatment of syphilis. A multivariate logistic regression analysis was conducted to identify possible factors associated with serological response, such as age, clinical stage, gender, initial rapid plasma regain （RPR） titer, administered drugs, and so on. Results One year after the recommended therapy, 152 out of the 226 patients achieved a serological cure, and 73 （32.4%） remained in the serofast state. The serofast rate increased with clinical course. The multivariate logistic regression analysis indicated that female patients （OR = 2.517, 95% CI： 1.159 - 5.464）, non-peniciUin treatment （OR = 4.959, 95% CI： 1.650 - 14.901） and a baseline RPR titer ≤ 1 ： 16 （OR = 4.370, 95% CI： 1.311 - 14.562） were associated with a higher serofast rate, while primary or secondary syphilis as well as young patients aged 25 years or less were associated with an increased likelihood of a serological cure （both P 〈 0.05）. Conclusion The serological response in patients after syphilis treatment is associated with clinical stage, gender, age, baseline RPR titer, and administered drugs.