Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China.
PLoS One. 2013 Jul 23;8(7):e70102. doi: 10.1371/journal.pone.0070102. Print 2013.
Some syphilis patients remain in a serologically active state after the recommended therapy. We currently know too little about the characteristics of this serological response.
We conducted a cohort study using the clinical database from Zhongshan Hospital, Medical College of Xiamen. In total, 1,327 HIV-negative patients with primary, secondary, latent, and tertiary syphilis were enrolled. Bivariate and multivariate analyses were utilised to identify factors associated with a serological cure and serofast state in syphilis patients one year after therapy. Chi-square tests were used to determine the differences in the serological cure rate across different therapy time points.
One year after the recommended therapy, 870 patients achieved a serological cure, and 457 patients (34.4%) remained in the serofast state. The serological cure rate increased only within the first 6 months. The bivariate analysis indicated that male or younger patients had a higher likelihood of a serological cure than female or older patients. Having a baseline titre ≤ 1∶2 or ≥ 1∶64 was associated with an increased likelihood of a serological cure. The serological cure rate decreased for the different disease stages in the order of primary, secondary, latent, and tertiary syphilis. A distinction should be drawn between early and late syphilis. The multivariate analysis indicated that a serological cure was significantly associated with the disease phase, gender, age, and baseline rapid plasma reagin (RPR) titre.
The serofast state is common in clinical work. After one year of the recommended therapy, quite a few syphilis patients remained RPR positive. The primary endpoint of the study indicated that disease phase, gender, age and baseline RPR titre were crucial factors associated with a serological cure.
一些梅毒患者在接受推荐的治疗后仍处于血清学活跃状态。我们目前对这种血清学反应的特征知之甚少。
我们使用厦门医学院中山医院的临床数据库进行了一项队列研究。共纳入 1327 例初发、二期、潜伏和三期梅毒的 HIV 阴性患者。采用单因素和多因素分析来确定与梅毒患者治疗后一年血清学治愈和血清固定状态相关的因素。卡方检验用于确定不同治疗时间点血清学治愈率的差异。
推荐治疗后 1 年，870 例患者达到血清学治愈，457 例（34.4%）仍处于血清固定状态。血清学治愈率仅在最初 6 个月内增加。单因素分析表明，男性或年轻患者比女性或老年患者更有可能达到血清学治愈。基线滴度≤1∶2 或≥1∶64 与血清学治愈的可能性增加相关。不同疾病阶段的血清学治愈率按原发性、二期、潜伏性和三期梅毒的顺序降低。应区分早期和晚期梅毒。多因素分析表明，血清学治愈与疾病阶段、性别、年龄和基线快速血浆反应素（RPR）滴度显著相关。
血清固定状态在临床工作中很常见。推荐治疗后 1 年，相当多的梅毒患者仍为 RPR 阳性。研究的主要终点表明，疾病阶段、性别、年龄和基线 RPR 滴度是与血清学治愈相关的重要因素。
