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目的分析40例二期梅毒患者的口腔临床特征及病理表现。方法收集北京大学口腔医学院1994至2004年间以口腔黏膜损害首诊的40例梅毒患者,对经实验室检查确诊的临床病理资料加以分析。结果40例二期梅毒患者中32例口腔表现为相似的黏膜斑,最好发的部位是舌。疼痛症状不明显或伴有轻微疼痛。对8例最初被误诊为口腔念珠菌病和扁平苔藓的患者,组织病理学检查显示为非特异性炎症,主要表现为上皮微脓肿,固有层血管周围有密集的淋巴细胞和浆细胞浸润。16例梅毒患者经苄星青霉素治疗后症状明显好转。结论以口腔黏膜损害为首发症状的梅毒患者有其特殊的临床病理学表现,但常易被口腔医务工作者忽视。口腔科医师应认识梅毒的口腔病损,及时诊断早期梅毒。
Objective To analyze the oral clinical features and pathological features of 40 patients with secondary syphilis. Methods Forty syphilitic patients with oral mucosal damage were collected from School of Stomatology, Peking University from 1994 to 2004, and the clinical and pathological data confirmed by laboratory examination were analyzed. Results Of the 40 patients with secondary syphilis, 32 cases showed similar mucosal lesions in oral cavity, and the best part was tongue. The pain is not obvious or accompanied by minor pain. Eight patients initially misdiagnosed as oral candidiasis and lichen planus showed histopathological findings as nonspecific inflammation, mainly in epithelial micro abscess with dense lymphocytes and plasma cell infiltration around the vessels in the lamina propria. Symptoms of 16 syphilis patients were significantly improved after treatment with benzathine. Conclusion Syphilis patients with oral mucosal lesion as the first symptom have their special clinicopathological manifestations, but they are often overlooked by dental workers. Stomatologists should be aware of syphilis oral lesions, timely diagnosis of early syphilis.