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目的通过临床分析及细胞免疫功能检测,探索梅毒血清固定发生的相关因素。方法选择54例梅毒血清固定患者,分析梅毒血清固定的发生与甲苯胺红不加热血清反应素试验(TRUST)初始滴度、疾病分期、治疗用药的关系。应用流式细胞仪检测54例梅毒血清固定患者与32例正常健康对照组外周血淋巴细胞亚群比例。结果一期梅毒血清固定者占1.85%(1/54),二期梅毒占11.11%(6/54),隐性梅毒占87.04%(47/54);梅毒血清固定患者中51例均应用苄星青霉素规范驱梅治疗,2例因青霉素过敏应用四环素替代治疗,1例一期梅毒应用罗氏芬治疗;与健康对照组相比,梅毒血清固定患者CD4+细胞比例(32.37±5.49)及NK细胞比例(18.39±7.93)均显著低于健康对照组(37.34±8.19,P<0.05;22.84±8.47,P<0.05)。结论隐性梅毒患者血清固定发生率高。CD4+T细胞及NK细胞减少可能与梅毒血清固定有关。
Objective To explore the related factors of syphilis serum fixation through clinical analysis and cellular immune function test. Methods Totally 54 patients with syphilis sera were selected to analyze the relationship between the incidence of syphilis sera and initial titers of TRUST, disease staging and therapeutic drug use. The proportion of peripheral blood lymphocyte subsets in 54 cases of syphilis serum-fixed patients and 32 healthy controls was detected by flow cytometry. Results In the first stage of syphilis, 1.85% (1/54) were seronegative, 11.11% (6/54) in second syphilis, 87.04% (47/54) in latent syphilis, and 51 Penicillin was used to drive the treatment of penicillin, 2 cases were treated with tetracycline replacement therapy due to penicillin allergy, and 1 case of syphilis was treated with rocessine. Compared with the healthy control group, the proportion of CD4 + cells (32.37 ± 5.49) and the proportion of NK cells (18.39 ± 7.93) were significantly lower than the healthy control group (37.34 ± 8.19, P <0.05; 22.84 ± 8.47, P <0.05). Conclusion Hidden syphilis patients with high incidence of serum fixation. CD4 + T cell and NK cell reduction may be related to syphilis serum fixation.