不同抗生素对早期梅毒的临床疗效观察

张海龙+陈泽伟+邱燕+林平+江丽君

【摘要】 目的：观察不同抗生素对早期梅毒的临床疗效观察。方法：随机选取于2014年5月-2015年

5月前来本科接受诊治的Ⅰ、Ⅱ期梅毒患者76例。通过随机数字法分为试验组（使用阿奇霉素治疗）和对照组（使用苄星青霉素治疗），每组各38例。观察临床皮疹消失时间；治疗前，治疗后3、6、9、12个月分别对患者进行甲苯胺红不加热血清试验（TRUST），对比两组患者不同时间点转阴率的情况及临床疗效。结果：试验组梅毒Ⅰ期梅毒皮疹症状消失时间为6 d左右，Ⅱ期梅毒为7 d左右；对照组梅毒Ⅰ期梅毒皮疹症状消失时间为6 d左右，Ⅱ期梅毒为8 d左右，两组临床皮疹症状消失时间两个时期比较，差异均无明显统计学意义（P>0.05）。两组患者治疗后转阴率随着时间的增加不断增加，试验组治疗后12个月达89.47%，对照组达86.84%，两组间转阴率比较差异无统计学意义（P>0.05）。试验组临床治愈率为84.21%，对照组临床治愈率为81.57%；试验组血清学治愈率为89.47%，对照组血清学治愈率为86.84%，两组患者的治愈率比较差异无统计学意义（P>0.05）。结论：阿奇霉素和苄星青霉素对早期梅毒的临床疗效均有效，两组间无疗效差异。

【关键词】 阿奇霉素； 苄星青霉素； 早期梅毒； 临床疗效

Clinical Observation of Different Antibiotics on Early Syphilis/ZHANG Hai-long，CHEN Ze-wei，QIU Yan，et al.//Medical Innovation of China，2017，14（10）：053-056

【Abstract】 Objective：To observe the clinical effect of different antibiotics on early syphilis.Method： 76 patients with stage Ⅰ and Ⅱ syphilis treated in our hospital from May 2014 to May 2015 were randomly selected，they were divided into experimental group（Azithromycin therapy） and control group（Benzylpenicillin therapy） according to random number table，38 cases in each group.The time of rash disappeared were observed.Before and after 3，6，9 and 12 months treatment，they were given plasma tolulizedred unheated serum test （TRUST）.The negative conversion rate of different time points and the clinical effect of two groups were compared.Result：In experimental group，the rash symptoms disappeared time in stage Ⅰ syphilis was about 6 d，in stage Ⅱ syphilis was about 7 d；in control group，the rash symptoms disappeared time in stage Ⅰ and Ⅱ syphilis was respectively 6 d and 8 d，there were no significant differences（P>0.05）.The negative conversion rate of two group increased with time，after 12 months of treatment，the negative conversion rate of experimental group was 89.47%，the control group was 86.84%，the difference was no statistically significant（P>0.05）.The clinical cure rate of experimental group was 84.21%，control group was 81.57%；the serological cure rate of experimental group was 89.47%，control group was 86.84%，the differences were no statistically significant（P>0.05）.Conclusion：The clinical effect of azithromycin and penicillin on early syphilis both are effective，there is no difference between the two groups.

【Key words】 Azithromycin； Benzylpenicillin； Early Syphilis； Clinical Efficacy

First-authors address：Dongkeng Hospital of Dongguan City，Dongguan 523450，China

doi：10.3969/j.issn.1674-4985.2017.10.015

梅毒是我國乃至全世界的主要性病传播病毒种类之一[1]，其主要由梅毒螺旋体构成，属于慢性、症状体征复杂多样化的系统性传性疾病[2]。根据目前的临床研究已证实性接触及血液传播是梅毒的主要散播途径，近年来其发病率逐年升高，且呈现年轻化的态势[3-4]。人类医学史记载，青霉素用于抗梅毒已有近百年历史[5-6]，但是由于青霉素的过敏反应限制了该药的运用，因此选择替代药物成为近年来医学工作者研究的热点。随着运用的不断推广及科研的不断深入，阿奇霉素因能适用于不愿进行青霉素皮试的患者或者青霉素过敏患者而逐渐进入医学工作者的视线。本研究对76例早期梅毒患者分别使用不同抗生素进行治疗，并对临床结果进行统计分析总结，具体情况汇报如下。