【摘要】 目的 观察使用苄星青霉素正规治疗早期显性梅毒的临床疗效以及分析治疗前后的梅毒血清学试验结果。 方法 选择2006年6月-2007年12月门诊就诊有皮肤损害的早期梅毒患者48例，病程lt;2年，采用苄星青霉素240万U，肌内注射，1次/周，连续3周治疗。治疗后随访第3、6、9、12、18、24个月时的TRUST滴度。 结果 48例早期梅毒患者经治疗后1个月内皮损均消失。总的血清转阴率为66.67%。一期梅毒在治疗后3、6个月时的TRUST转阴率较二期梅毒高（Plt;0.05）。治疗前TRUST≥1∶8者TRUST滴度在治疗后下降较TRUST≤1∶4者快（Plt;0.05）。 结论 早期梅毒病程越短，治愈越快。治疗前血清学滴度越高，治疗后滴度下降越快。梅毒的治疗应强调早期、规范。【Abstract】 Objective To analyze the clinical efficiency and pre- and post- therapy serological results of benzathine benzylpenicillin treated for early symptomatic syphilis. Methods A total of 48 patients with early symptomatic syphilis diagnosed from June 2006 to December 2007 (the disease durationlt;2 years) were treated with benzathine benzylpenicillin. The patients underwent the intramuscular injection with 2.4 million units benzathine benzylpenicillin once per week (for continuous 3 weeks). The results of TRUST were detected 3,6,9,12,18,and 24 months after the treatment. Results All patients cured clinically within one month. The general seronegative rate was 66.67%. Three and six months after the treatment, the seronegative rate of primary syphilis were higher than that of secondary syphilis (Plt;0.05). The TRUST titer dropped faster after the treatment in the ones whose TRUST titer was ≥1∶8 than those whose TRUST titer was ≤1∶4 (Plt;0.05). Conclusion The shorter the duration of infection is, the faster the treatment may be. The higher the TRUST titers before the treatment are, the faster the titers decrease is. The treatment on syphilis should be as early as possible.
目的：总结我们对表现为麻痹性痴呆的晚期神经梅毒的诊治经验。方法：报道4例麻痹性痴呆病例，并复习相关文献。结果和结论：麻痹性痴呆的临床表现复杂多变，早期误诊率高；诊断主要根据临床特点、血清学及脑脊液检查综合考虑；治疗上仍首选水剂青霉素G。
Objective To evaluate the clinical features and treatment outcomes of ocular posterior segment syphilis. Methods The clinical data of 24 patients with active ocular syphilis were retrospectively reviewed. The diagnosis was made first in eye clinic，and verified by treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR). The patients, 17 males and 7 females, aged from 30 to 63 years with an average of 47.6 years. The duration of symptoms ranged from 3 days to 2 years with an average of 5.8 months (le;1 month, 7 cases; 1-3 month, 5 cases; 3-6 months, 5 cases; ＞6 months, 7 cases). There were 18 bilateral cases and 6 unilateral cases. The result of human immunodeficiency virus (HIV) test was negative for all cases. Twenty-three patients received systemic penicillin therapy and 1 patient was treated with oral erythromycin due to penicillin allergy. Before treatment, the mean visual acuity was 0.17plusmn;0.19，the mean titer of RPR was 1:84。The follow-up period was half a year. Results The major ocular manifestations included bilateral (16 cases) or unilateral (1 case) chorioretinitis, unilateral retinal vasculitis (2 cases), unilateral neuroretinitis (2 cases), and bilateral (2 cases) or unilateral (1 case) optic neuritis. The mean follow-up visual acuity was 0.60plusmn;0.29，the mean follow-up titer of RPR was1:18.8. Some patients had got the diagnosis and prompt treatment at the early stage of the disease and their visual acuity recoveried very well. Conclusions The major manifestion of ocular posterior segment syphilis is chorioretinitis. It is important to consider the possibility of syphilis when patients have inflammation of posterior segment. Prompt serology examination and penicillin treatment are the keys to cure ocular syphilis.