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美满霉素治疗早期梅毒的疗效。

Efficacy of minocycline in the treatment of early syphilis.

机构信息

Department of Dermatovenereology, 117865Tianjin Medical University General Hospital, Tianjin, China.

出版信息

Int J STD AIDS. 2021 Jun;32(7):648-653. doi: 10.1177/0956462420984695. Epub 2021 Jan 26.

DOI:10.1177/0956462420984695
PMID:33496202
Abstract

Syphilis is the third prevalent infectious disease in China, caused by the spirochete bacterium . Minocycline is a derivative of tetracycline used as an alternative treatment for syphilis, but there are few studies in this field. In this research, we compared the efficacy of benzathine penicillin and minocycline in the treatment of early syphilis patients and analyzed some of the factors affecting the efficacy of minocycline. A total of 276 eligible patients treated between January 2011 and December 2017 were retrospectively analyzed, and 158 patients received 100 mg of minocycline orally, twice daily for 28 days, while 118 patients received benzathine penicillin, 2.4 million units intramuscular injections, once a week, 1-2 times in all. All patients accepted rapid plasma regain (RPR) serological tests and followed up for 24 months to evaluate serological treatment responses. After comparison, the serological cure rate of the minocycline treatment group (85.44%) was similar to the benzathine penicillin treatment group (88.14%). Besides, patients in the minocycline treatment group with higher initial RPR titer (≥1:32) exhibited better treatment effect. In addition, during the 24-month follow-up, the serological cure rate of primary syphilis patients after minocycline treatment was significantly higher than that of secondary and early latent syphilis patients. Therefore, minocycline may be an effective alternative treatment to early syphilis when benzathine penicillin is not available.

摘要

梅毒是中国第三大常见传染病,由螺旋体细菌引起。米诺环素是四环素的衍生物,可用作治疗梅毒的替代药物,但该领域的研究较少。在这项研究中,我们比较了苄星青霉素和米诺环素治疗早期梅毒患者的疗效,并分析了影响米诺环素疗效的一些因素。回顾性分析了 2011 年 1 月至 2017 年 12 月期间治疗的 276 例符合条件的患者,其中 158 例患者口服 100mg 米诺环素,每日 2 次,共 28 天,118 例患者接受苄星青霉素 240 万单位肌内注射,每周 1 次,共 1-2 次。所有患者均接受快速血浆反应素(RPR)血清学检测,并随访 24 个月以评估血清学治疗反应。比较后,米诺环素治疗组(85.44%)的血清学治愈率与苄星青霉素治疗组(88.14%)相似。此外,米诺环素治疗组中初始 RPR 滴度较高(≥1:32)的患者治疗效果更好。此外,在 24 个月的随访中,米诺环素治疗原发性梅毒患者的血清学治愈率明显高于二期和早期潜伏梅毒患者。因此,当苄星青霉素不可用时,米诺环素可能是早期梅毒的有效替代治疗药物。

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