摘要
目的探讨硬下疳梅毒患者梅毒螺旋体(TP)基因分型与神经损害的相关性。方法选取2015年3月至2018年3月台州医院接收的104例硬下疳梅毒患者的临床资料作回顾性分析。取皮损组织液,采用三基因分型法(arp、tpr、tp0548)检测TP基因分型,并综合分析判断梅毒基因分型。根据神经电生理检查判断是否发生神经损害,将其分为发生组和未发生组;统计不同基因分型患者神经损害发生构成比,应用单因素和多因素Logistic回归分析法明确影响硬下疳梅毒患者神经损害的危险因素。结果arp基因分型共12种(14、15、16、17、13、10、16、18、5、7、12、25),tpr基因分型共4种(a、d、h、l),tp0548基因分型共3种(c、f、e)。综合分析共分出16种基因分型,其中14d/f构成比(34.62%)最高,其次为15d/f(14.42%)、16d/f(12.50%)、17d/f(9.62%)、13d/f(6.37%)、10d/f(4.81%)。硬下疳梅毒患者中共发生14例神经损害,其中TP基因分型为14d/f的患者神经损害发生率为71.43%,其次为15d/f、16d/f、10d/f、5d/f,均为7.14%。发生组和未发生组性别、年龄、婚姻状况、HIV感染、血RPR滴度≥8、脑脊液RPR滴度≥8、高颅内压患者构成比比较,差异均无统计学意义(均P>0.05),发生组无正规治疗史、血TRUST滴度≥8、脑脊液蛋白浓度≥100mg/dL、基因分型为14d/f患者的构成比高于未发生组,差异均具有统计学意义(均P<0.05),且经Logistic回归分析证实均是导致硬下疳梅毒患者发生神经损害的危险因素(均P<0.05)。结论硬下疳梅毒患者TP基因分型以14d/f型为主,且14d/f型是导致硬下疳梅毒患者发生神经损害的危险因素。
Objective To investigate the correlation between genotyping of treponema pallidum(TP)and neurological damage in syphilis patients with hard chancres.Methods Retrospective analysis of clinical data of 104 syphilis patients with hard chancres admitted to Taizhou Hospital from March 2015 to March 2018.The skin tissue was collected and the genotyping of TP was performed by three-genome(arp,tpr,tp0548),and the genotyping of syphilis was determined by comprehensive analysis.According to the neuroelectrophysiological examination to determine whether nerve damage occurred,it was divided into the occurrence group and the non-occurrence group.The incidence and composition ratio of nerve damage in patients with different genotypes were calculated.Univariate and multivariate Logistic regression analysis was used to determine the risk factors of nerve damage in syphilis patients with hard chancres.Results There are 12 arp genotypes(14,15,16,17,13,10,16,18,5,7,12,25),4 tpr genotypes(a,d,h,l),and 3 tp0548 genotypes(c,f,e).A total of 16 genotypes were analyzed,of which 14d/f was the highest(34.62%),followed by 15d/f(14.42%),16d/f(12.50%),17d/f(9.62%),13d/f(6.37%),and 10d/f(4.81%).A total of 14 cases of nerve damage occurred in syphilis patients with hard chancres.The incidence of neurological damage in patients with TP genotype of 14d/f was 71.43%,followed by 15d/f,16d/f,10d/f,5d/f,7.14%.There were no significant differences in the proportion of gender,age,marital status,HIV infection,blood RPR titer≥8,cerebrospinal fluid RPR titer≥8 and high intracranial pressure(all P>0.05)between the occurrence group and the non-occurrence group.The proportion of patients with no history of normal treatment,blood TRUST titer≥8,cerebrospinal fluid protein concentration≥100mg/dL and genotype 14d/f in the incidence group was higher than that in the non-incidence group,and the differences were statistically significant(all P<0.05).Logistic regression analysis confirmed that all of them were risk factors for nerve damage in syphilis patients with hard chancres(all P<0.05).Conclusions 14D/F is the main type among the TP genotyping,which is a risk factor for neurological damage in syphilis patients with hard chancres.
作者
郑伟青
朱希聪
ZHENG Weiqing;ZHU Xicong(Department of Dermatology,Taizhou Hospital,Taizhou 317000,Zhejiang,China)
出处
《中国性科学》
2020年第11期128-131,共4页
Chinese Journal of Human Sexuality
关键词
硬下疳梅毒
梅毒螺旋体
基因分型
神经损害
危险因素
Syphilis with hard chancres
Treponema pallidum
Genotyping
Nerve damage
Risk factors
