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目的探讨晚期梅毒患者治疗后的血清学反应。方法选择2012年1月—2015年2月在我院治疗的梅毒患者为研究对象,123例为有症状的神经梅毒,9例患者为无症状神经梅毒,21例为隐性梅毒。分析患者治疗后血清及脑脊液RPR滴度变化,比较滴度升高患者与未升高患者一般资料的差异。结果所有患者在治疗1个月时复查RPR滴度,48例患者滴度升高,占31.4%;15例患者滴度升高4倍及以上,余升高2倍。48例滴度升高的患者,隐性梅毒患者4例,无症状神经梅毒1例升高,有症状神经梅毒43例,有症状神经梅毒治疗1个月后滴度升高比例最高。123例有症状神经梅毒患者复查脑脊液RPR,7例患者脑脊液RPR滴度升高,占5.7%。男性,年龄36岁~45岁的患者,治疗后RPR滴度升高的发生率更高(P<0.05或<0.01)。结论晚期梅毒患者经正规驱梅治疗后1个月,有部分患者RPR滴度反而上升,临床上应予以重视,必要时进行重复驱梅治疗,以提高远期疗效。
Objective To investigate the serological response of patients with advanced syphilis after treatment. Methods The syphilis patients treated in our hospital from January 2012 to February 2015 were selected as the study subjects, 123 as symptomatic neurosyphilis, 9 asymptomatic neurosyphilis and 21 as latent syphilis. Analysis of patients after treatment serum and cerebrospinal fluid RPR titer changes, comparing patients with elevated titer and non-elevated general information differences. Results All patients underwent RPR titration at 1 month of treatment. The titer of the RPR was increased in 48 patients (31.4%). The titers of all the 15 patients were increased by 4 times or more and the remaining 2 times. 48 cases of patients with elevated titers, 4 cases of latent syphilis, asymptomatic neurosyphilis increased in 1 case, 43 cases of symptomatic neurosyphilis, symptomatic neurosyphilis after treatment for 1 month the highest proportion of the highest increase in titer. Cerebral spinal fluid RPR was reviewed in 123 patients with symptomatic neurosyphilis, and the RPR titer in CSF was elevated in 7 patients (5.7%). Men, aged 36-45 years, had a higher incidence of elevated RPR titer (P <0.05 or <0.01) after treatment. Conclusions In patients with advanced syphilis, one month after regular flooding treatment, RPR titration in some patients increased instead. In clinic, attention should be paid to the use of repeated flooding therapy to improve long-term efficacy.