吉林省长春地区梅毒流行病学特征及预后相关因素研究

发布时间：2018-05-26 02:27

本文选题：性传播疾病 + 梅毒　；参考：《延边大学》2017年硕士论文

【摘要】：目的:探讨自2013年1月至2015年12月于吉林大学第二医院诊疗的梅毒患者的流行病学特征以及影响梅毒预后的相关因素,为梅毒的防治提供依据。方法:以自2013年1月至2015年12月在吉林大学第二医院诊疗且规范驱梅治疗两年的梅毒患者共294人为研究对象,采集患者的流行病学特征、临床特点,进行RPR滴度、TP检测,对于TP及RPR阳性的患者,确定其临床诊断与分期。建立EXCEL随访数据库,对随访资料完整的患者进行相关因素对患者病情及预后的影响研究。结果:2013年1月～2015年12月,于吉林大学第二医院进行规范驱梅且定期随访的患者共计294例。其中(1)男性118例,占就诊患者的40.14%,女性患者176例,占就诊患者的59.86%,男女之比0.67:1,女性患者约为男性患者的1.5倍。文盲28例,占就诊患者的9.52%,小学文化8例(占2.72%),初中文化128例(占43.54%),高中、职中70例(占23.81%),大学45例(占15.31%),硕士及以上15例(占5.10%)。文化程度为初中及初中以下病患共计164例,占到总患者量的55.78%。(2)以异性性传播为主(占总数的91.84%),其次为同性性传播(占总数的1.36%),医源性传播占总数的0.68%,母婴途径传播占总数的3.40%,途径未知者占到总数的2.72%。(3)一期梅毒9例(3.06%),二期梅毒141例(47.96%),三期梅毒2例(0.68%),潜伏梅毒132例(44.90%),胎传梅毒10例(3.40%)。(4)合并HIV、生殖器疱疹者共19例,其中合并HIV感染者3例(男性2例、女性1例),占1.02%;合并生殖器疱疹者15例(男性10例、女性5例),占5.10%,同时合并HIV、生殖器疱疹者1例(男性),占0.34%。(5)以苄星青霉素为药物进行治疗的为278例(占总患者数的94.56%),利用阿奇霉素进行驱梅治疗的共计12例(占总患者数的4.08%),使用头孢曲松钠进行治疗的为4例(占总患者数的1.36%)。经规范治疗,苄星青霉素方案治疗后RPR转阴率为90.28%,其他方案治疗后,转阴率为62.50%。苄星青霉素方案治疗后,一期梅毒转阴率达100%,远超过二期梅毒的转阴率90.84%,潜伏期梅毒90.63%、和胎传梅毒转阴率87.50%,而三期梅毒转阴率为0%。结论:(1)吉林省长春地区梅毒患者男女发病比例为0.67:1,女性患者约为男性患者的1.5倍;(2)吉林省长春地区梅毒发病人群中以初中及初中以下文化程度为主,青年人与低文化人群是重点关注的对象;(3)吉林省长春地区梅毒的传播途径以异性性传播为主;(4)吉林省长春地区梅毒的临床分期以二期梅毒和潜伏梅毒为主;(5)吉林省长春地区利用苄星青霉素方案进行驱梅的患者,转阴率达90.29%,明显超过其他方案(62.50%)。(6)吉林省长春地区一期梅毒患者RPR转阴率最高,100%的一期梅毒患者RPR滴度转阴,显著高于二期梅毒90.84%及潜伏梅毒90.63%的转阴率。而三期梅毒转阴率为0。
[Abstract]:Objective: to investigate the epidemiological characteristics of syphilis patients treated in the second Hospital of Jilin University from January 2013 to December 2015 and the related factors affecting the prognosis of syphilis so as to provide evidence for the prevention and treatment of syphilis. Methods: 294 syphilis patients who were diagnosed and treated in the second Hospital of Jilin University from January 2013 to December 2015 were studied. The epidemiological and clinical characteristics of syphilis patients were collected and the titer of RPR was detected. The clinical diagnosis and staging of TP and RPR positive patients were determined. EXCEL follow-up database was established to study the influence of related factors on patients' condition and prognosis. Results: from January 2013 to December 2015 294 patients were regularly followed up in the second Hospital of Jilin University. Among them, 118 cases (40.14%) were male, 176 cases were female, and 59.86% (male / female). The ratio of male to female was 0.67: 1. The ratio of female patient to male patient was about 1.5 times that of male patient. There were 28 cases of illiteracy, 8 cases of primary school culture (2.72%), 128 cases of junior high school culture (43.54%), 70 cases of senior high school (23.81%), 45 cases of university (15.31%), 15 cases of master's degree and above (5.10%). A total of 164 patients with educational level in junior high school and below junior middle school, (91.84% of the total, followed by same-sex transmission (1.36% of the total, 0.68% of the total number of iatrogenic transmission, 3.40% of the total number of mother-to-child transmission, 2.72% of the total number of people with unknown routes accounted for 2.72% of the total), 55.78% of the total number of patients is mainly heterosexual transmission (91.84% of the total, followed by same-sex transmission (1.36% of the total, iatrogenic transmission accounts for 0.68% of the total). There were 9 cases of syphilis, 141 cases of secondary syphilis, 47.96% of secondary syphilis, 2 cases of third stage syphilis, 0.68 cases of syphilis, 132 cases of latent syphilis, 44.90% of them, 10 cases of fetal syphilis, 10 cases of fetal syphilis, and 19 cases of genital herpes. Among them, 3 cases were complicated with HIV infection (male 2 cases, female 1 case) and 15 cases (male 10 cases) with genital herpes. There were 5 women (5.10%), 1 case (male, 0.34%) with genital herpes, 278 cases (94.56%) treated with benzylpenicillin (94.56% of total patients), 12 cases (12 cases) treated with azithromycin. 4.08% of total patients and 4 cases treated with ceftriaxone sodium (1.36% of total patients). After standard treatment, the negative rate of RPR was 90.28 after benzylpenicillin regimen, and 62.50 after other regimens. The conversion rate of primary syphilis was 100, which was much higher than that of secondary syphilis, the latent period of syphilis was 90.63, and the rate of fetal syphilis turned negative was 87.50, while the rate of third stage syphilis turned negative was 0. Conclusion the incidence ratio of syphilis in Changchun area of Jilin Province is 0.67: 1, and that of female patients is about 1.5 times that of male patients. In Changchun area of Jilin Province, the incidence of syphilis is mainly from junior middle school and below junior middle school. Young people and low-educated people are the focus of attention) the transmission of syphilis in Changchun area of Jilin Province is mainly heterosexual transmission. 4) the clinical stage of syphilis in Changchun area of Jilin Province is mainly secondary syphilis and latent syphilis. Patients in Changchun province using benzylpenicillin scheme to drive out plum, The rate of turning negative was 90.29, which was obviously higher than that of other schemes (62.50%) the rate of RPR turning negative in primary syphilis patients in Changchun area of Jilin Province was 100%, which was significantly higher than that of secondary syphilis (90.84%) and latent syphilis (90.63%). The negative rate of third stage syphilis was 0. 5%.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R759.1;R181.3

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