發(fā)布時間：2018-05-26 02:27

  本文選題：性傳播疾病 + 梅毒　； 參考：《延邊大學(xué)》2017年碩士論文

【摘要】：目的:探討自2013年1月至2015年12月于吉林大學(xué)第二醫(yī)院診療的梅毒患者的流行病學(xué)特征以及影響梅毒預(yù)后的相關(guān)因素,為梅毒的防治提供依據(jù)。方法:以自2013年1月至2015年12月在吉林大學(xué)第二醫(yī)院診療且規(guī)范驅(qū)梅治療兩年的梅毒患者共294人為研究對象,采集患者的流行病學(xué)特征、臨床特點(diǎn),進(jìn)行RPR滴度、TP檢測,對于TP及RPR陽性的患者,確定其臨床診斷與分期。建立EXCEL隨訪數(shù)據(jù)庫,對隨訪資料完整的患者進(jìn)行相關(guān)因素對患者病情及預(yù)后的影響研究。結(jié)果:2013年1月～2015年12月,于吉林大學(xué)第二醫(yī)院進(jìn)行規(guī)范驅(qū)梅且定期隨訪的患者共計294例。其中(1)男性118例,占就診患者的40.14%,女性患者176例,占就診患者的59.86%,男女之比0.67:1,女性患者約為男性患者的1.5倍。文盲28例,占就診患者的9.52%,小學(xué)文化8例(占2.72%),初中文化128例(占43.54%),高中、職中70例(占23.81%),大學(xué)45例(占15.31%),碩士及以上15例(占5.10%)。文化程度為初中及初中以下病患共計164例,占到總患者量的55.78%。(2)以異性性傳播為主(占總數(shù)的91.84%),其次為同性性傳播(占總數(shù)的1.36%),醫(yī)源性傳播占總數(shù)的0.68%,母嬰途徑傳播占總數(shù)的3.40%,途徑未知者占到總數(shù)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%),潛伏梅毒132例(44.90%),胎傳梅毒10例(3.40%)。(4)合并HIV、生殖器皰疹者共19例,其中合并HIV感染者3例(男性2例、女性1例),占1.02%;合并生殖器皰疹者15例(男性10例、女性5例),占5.10%,同時合并HIV、生殖器皰疹者1例(男性),占0.34%。(5)以芐星青霉素為藥物進(jìn)行治療的為278例(占總患者數(shù)的94.56%),利用阿奇霉素進(jìn)行驅(qū)梅治療的共計12例(占總患者數(shù)的4.08%),使用頭孢曲松鈉進(jìn)行治療的為4例(占總患者數(shù)的1.36%)。經(jīng)規(guī)范治療,芐星青霉素方案治療后RPR轉(zhuǎn)陰率為90.28%,其他方案治療后,轉(zhuǎn)陰率為62.50%。芐星青霉素方案治療后,一期梅毒轉(zhuǎn)陰率達(dá)100%,遠(yuǎn)超過二期梅毒的轉(zhuǎn)陰率90.84%,潛伏期梅毒90.63%、和胎傳梅毒轉(zhuǎn)陰率87.50%,而三期梅毒轉(zhuǎn)陰率為0%。結(jié)論:(1)吉林省長春地區(qū)梅毒患者男女發(fā)病比例為0.67:1,女性患者約為男性患者的1.5倍;(2)吉林省長春地區(qū)梅毒發(fā)病人群中以初中及初中以下文化程度為主,青年人與低文化人群是重點(diǎn)關(guān)注的對象;(3)吉林省長春地區(qū)梅毒的傳播途徑以異性性傳播為主;(4)吉林省長春地區(qū)梅毒的臨床分期以二期梅毒和潛伏梅毒為主;(5)吉林省長春地區(qū)利用芐星青霉素方案進(jìn)行驅(qū)梅的患者,轉(zhuǎn)陰率達(dá)90.29%,明顯超過其他方案(62.50%)。(6)吉林省長春地區(qū)一期梅毒患者RPR轉(zhuǎn)陰率最高,100%的一期梅毒患者RPR滴度轉(zhuǎn)陰,顯著高于二期梅毒90.84%及潛伏梅毒90.63%的轉(zhuǎn)陰率。而三期梅毒轉(zhuǎn)陰率為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%.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R759.1;R181.3

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