Department of Infectious Diseases, Shonan Memorial Hospital, Kamakura, Kanagawa, Japan; Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan.
Department of Rehabilitation, Shonan Memorial Hospital, Kamakura, Kanagawa, Japan.
J Infect Chemother. 2022 Apr;28(4):492-495. doi: 10.1016/j.jiac.2021.12.009. Epub 2021 Dec 20.
We investigated the association between stroke and asymptomatic latent syphilis (ALS) in geriatric patients.
This retrospective observational study included patients aged >65 years who underwent routine qualitative rapid plasma reagin (RPR) and Treponema pallidum Latex Agglutination (TPLA) tests at a 161-bed community acute care hospital with long-term care facilities in Kamakura, Japan, from August 2014 to February 2019. Asymptomatic patients with a positive TPLA test result were diagnosed with ALS. Ninety-six patients with ALS were included in the study. Fifty-one patients (53.1%) had a positive RPR test. Comorbidities included hypertension (n = 44; 45.8%), chronic kidney disease (n = 44; 45.8%), and fracture (n = 29; 30.2%). No significant differences were found in sex, age, or comorbidities in univariate analyses. Multivariate analysis of the TPLA-positive geriatric patients revealed that a positive RPR test (odds ratio = 9.06; 95% confidence interval = 1.69-48.5; p = 0.01) was associated with a history of stroke.
For geriatric patients with ALS, a positive qualitative RPR test was associated with a history of stroke. Medical evaluation and management of the risk factors for stroke are more necessary for ALS with a positive RPR qualitative test.
我们研究了老年患者中风与无症状潜伏梅毒（ALS）之间的关系。
本回顾性观察研究纳入了 2014 年 8 月至 2019 年 2 月在日本镰仓一家拥有长期护理设施、拥有 161 张床位的社区急性护理医院接受常规定性快速血浆反应素（RPR）和梅毒螺旋体乳胶凝集（TPLA）检测的年龄＞65 岁的患者。TPLA 检测结果阳性的无症状患者被诊断为 ALS。本研究纳入了 96 例 ALS 患者。51 例（53.1%）患者 RPR 检测阳性。合并症包括高血压（n=44；45.8%）、慢性肾脏病（n=44；45.8%）和骨折（n=29；30.2%）。单因素分析未发现性别、年龄或合并症存在差异。对 TPLA 阳性老年患者的多因素分析显示，RPR 检测阳性（比值比=9.06；95%置信区间=1.69-48.5；p=0.01）与中风病史相关。
对于 ALS 老年患者，RPR 定性检测阳性与中风病史相关。对于 RPR 定性检测阳性的 ALS 患者，更有必要评估和管理中风的危险因素。
