20例梅毒血清固定患者的临床分析
发布时间：2019-03-22 18:00
【摘要】： 目的探讨引起梅毒血清固定的可能原因 方法通过对20例梅毒血清固定患者进行脑脊液(CSF)常规、生化检测及RPR、TPPA测定,同时检测外周血细胞免疫和体液免疫功能以及内脏多器官影像学检查。所有患者均按照神经梅毒规范治疗,分别于三月后复查外周血RPR定量试验。 结果本组20例患者中有4例(20.0%)CSF-TPPA(+),其中1例CSF-RPR(+),未发现CSF中有蛋白及白细胞增高。2例(10.0%)外周血IgM水平升高、C 3降低,14例(70.0%)患者细胞毒/抑制T细胞(CD8/3)增加、辅助/诱导记忆T细胞(CD4/3)减少。3例(15.0%)心脏彩超分别发现左室松弛减退,主动脉瓣回声稍强和二尖瓣退行性变。5例(25.0%)脑CT、MRI发现脑萎缩及多发腔隙灶。根据病史18例(90.0%)于不洁性交史后超过半年以上的时间才开始规范化治疗,初始使用使用苄星青霉素240万U/周,连续3次治疗。2例(10.0%)使用美满霉素或者阿奇霉素。确诊为血清固定后,均按神经梅毒治疗方案治疗后3个月所有患者血清RPR滴度未降低。 结论治疗未能及时、选药不当、潜在器官梅毒和免疫异常可能是引起梅毒患者血清固定的原因。
[Abstract]:Objective to explore the possible causes of syphilis serofixation methods routine, biochemical and RPR,TPPA tests of cerebrospinal fluid (CSF) were performed in 20 patients with syphilis serum fixation. Meanwhile, peripheral blood cell immunity and humoral immune function as well as imaging examination of visceral multiple organs were detected. All the patients were treated according to the criteria of neurosyphilis. The peripheral blood RPR quantitative test was reexamined three months later. Results among the 20 patients, 4 (20.0%) cases were CSF-TPPA (), 1 case (CSF-RPR (),) had no increase in protein and leukocyte in CSF, 2 cases (10.0%) had increased IgM level in peripheral blood, and C 3 decreased, but there was no significant difference between two cases (10.0%) and the control group (P < 0.05). Cytotoxic / inhibitory T cells (CD8/3) increased and helper / induced memory T cells (CD4/3) decreased in 14 patients (70.0%), left ventricular relaxation was found in 3 patients (15.0%), and left ventricular relaxation was decreased in 3 patients (15.0%). In 5 cases (25.0%), cerebral atrophy and multiple lacunar foci were found on CT,MRI. According to the history of 18 cases (90.0%), more than half a year after the history of unclean sexual intercourse began standardized treatment, the initial use of benzylpenicillin 2.4 million U / week. Two cases (10.0%) were treated with methamphenicol or azithromycin. The serum RPR titers of all patients did not decrease 3 months after treatment according to neurosyphilis treatment. Conclusion the failure of treatment in time, improper selection of drugs, potential organ syphilis and immune abnormalities may be the causes of serum fixation in syphilis patients.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R759.1
本文编号：2445801
[Abstract]:Objective to explore the possible causes of syphilis serofixation methods routine, biochemical and RPR,TPPA tests of cerebrospinal fluid (CSF) were performed in 20 patients with syphilis serum fixation. Meanwhile, peripheral blood cell immunity and humoral immune function as well as imaging examination of visceral multiple organs were detected. All the patients were treated according to the criteria of neurosyphilis. The peripheral blood RPR quantitative test was reexamined three months later. Results among the 20 patients, 4 (20.0%) cases were CSF-TPPA (), 1 case (CSF-RPR (),) had no increase in protein and leukocyte in CSF, 2 cases (10.0%) had increased IgM level in peripheral blood, and C 3 decreased, but there was no significant difference between two cases (10.0%) and the control group (P < 0.05). Cytotoxic / inhibitory T cells (CD8/3) increased and helper / induced memory T cells (CD4/3) decreased in 14 patients (70.0%), left ventricular relaxation was found in 3 patients (15.0%), and left ventricular relaxation was decreased in 3 patients (15.0%). In 5 cases (25.0%), cerebral atrophy and multiple lacunar foci were found on CT,MRI. According to the history of 18 cases (90.0%), more than half a year after the history of unclean sexual intercourse began standardized treatment, the initial use of benzylpenicillin 2.4 million U / week. Two cases (10.0%) were treated with methamphenicol or azithromycin. The serum RPR titers of all patients did not decrease 3 months after treatment according to neurosyphilis treatment. Conclusion the failure of treatment in time, improper selection of drugs, potential organ syphilis and immune abnormalities may be the causes of serum fixation in syphilis patients.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R759.1
【参考文献】
相关期刊论文 前10条
1 杨日东,程军平,田广南,蔡川川,张文君,林仕英,陈展琳,梁幕兰;梅毒血浆反应素快速试验持续阳性患者外周血淋巴细胞亚群的检测及其临床意义[J];第一军医大学学报;2003年12期
2 杨文林,杨健,黄新宇;近10年梅毒血清固定患者临床分析[J];临床皮肤科杂志;2005年11期
3 施辛,戚宝康;头孢曲松治疗早期梅毒血清固定近期疗效观察[J];中国麻风皮肤病杂志;2002年04期
4 杨日东,李季,梁艳华,邓建华,黎小东,蔡川川,田广南;梅毒患者脑脊液检测的意义[J];中国麻风皮肤病杂志;2004年03期
5 胡蔚毅,钱伊弘,张刚,陈霞凤,乐嘉豫;6种抗生素治疗早期梅毒的疗效对比研究[J];中国麻风皮肤病杂志;2005年10期
6 杨立刚,张锡宝,钟山;阿齐霉素对早期梅毒的治疗效果(附14例疗效观察)[J];中国热带医学;2004年05期
7 施辛,张秉正,包仕尧,黄强;神经梅毒的临床特征与处理(二)[J];中国皮肤性病学杂志;2001年04期
8 杨日东,李季,梁艳华,陶小华,蔡川川;RPR持续阳性梅毒患者脑脊液梅毒检测的意义[J];中国皮肤性病学杂志;2004年03期
9 侯青,孔立;梅毒患者12例治疗后血清非梅毒螺旋体抗原试验长期未转阴的临床分析[J];职业与健康;2003年05期
10 王林娜;左亚刚;刘永鑫;刘秀荣;郑和义;;梅毒血清抵抗发生率及其相关因素[J];中国医学科学院学报;2008年03期
，本文编号：2445801
本文链接：https://www.wllwen.com/yixuelunwen/yank/2445801.html
最近更新
教材专著
