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目的探讨头孢曲松钠治疗早期神经梅毒的临床疗效。方法对早期梅毒(一、二期梅毒)患者进行血清学及脑脊液检查,将确诊的28例无症状神经梅毒和4例梅毒性脑膜炎随机分成两组,均住院接受治疗,其中头孢曲松钠组17例,予头孢曲松钠2g/d静脉滴注,连续14d;青霉素组15例,应用水剂青霉素治疗,400万U/次静脉滴注,每4h一次,连续14d。结果治疗后6个月,头孢曲松钠组和青霉素组血清学RPR滴度分别有16例(94.1%)、14例(93.3%)不同程度的下降,其中分别有7例(41.2%)、7例(46.7%)下降4倍及以上。CSF RPR滴度分别有9例(52.9%)、8例(53.3%)出现下降;治疗后12个月两组分别有14例(82.4%)、13例(86.7%)血清学及CSF RPR同时转阴;治疗后18个月两组分别有16例(94.1%)、14例(93.3%)血清学及CSF RPR转阴,各有1例仍未转阴,但血清学RPR滴度持续下降,目前仍在随访。两组差异无统计学意义(P>0.05)。结论头孢曲松钠可以替代水剂青霉素,作为治疗早期神经梅毒的有效药物。
Objective To investigate the clinical efficacy of ceftriaxone sodium in the treatment of early neurosyphilis. Methods Serological and cerebrospinal fluid (CSF) tests were performed on patients with early syphilis (stage I and stage II syphilis). The 28 cases of asymptomatic neurosyphilis and 4 cases of syphilitic meningitis were randomly divided into two groups and were admitted to hospital. Among them, ceftriaxone sodium Group, 17 cases were given ceftriaxone sodium 2g / d intravenously for 14 days. In penicillin group, 15 cases were treated with water penicillin, 4 million U / times intravenous drip once every 4 hours for 14 days. Results Serum RPR titres in ceftriaxone sodium group and penicillin group were decreased in 16 cases (94.1%) and 14 cases (93.3%) in 6 months after treatment, respectively, of which 7 cases (41.2%), 7 cases (46.7%) decreased 4 times and above. CSF RPR titers were decreased in 9 cases (52.9%) and 8 cases (53.3%) in 14 cases (82.4%) and 13 cases (86.7% (94.1%), serological and CSF RPR in 14 cases (93.3%) were negative in 18 months after treatment, and one case had not yet been negative, but the serum RPR titer continued to decrease , Is still under follow-up. There was no significant difference between the two groups (P> 0.05). Conclusion Ceftriaxone sodium can replace water agent penicillin, as an effective drug for the treatment of early neurosyphilis.