The Analysis Of The Influencing Factors And Retreatment Value Of Syphilis Serofast

Objective:Syphilis is a notifiable infectious disease and one of the major sexually transmitted diseases in China.In recent years,the rate of incidence and serofast are still on the rise,which seriously threatens health of patients including the physical and mental and brings hazard for community.So it is vital to prevent syphilis and serofast.However,the mechanism and influencing factors of serofast are not clear at home and abroad,and retreatment is still controversial.By collecting the clinical data and laboratory results of syphilis patients treated in the dermatology department of Shengjing Hospital of China Medical University,and analyze the factors related to the serofast and the outcome of retreatment in syphilis patients,to explore the influencing factors and retreatment value of serofast,and to provide reference for clinical.Methods:1.Study on the factors related to serofast:The data(including gender,age,symptoms and signs,diagnosis,treatment)and corresponding laboratory test results(including RPR,TPPA at initial diagnosis and follow-up,and HIV at initial diagnosis)of HIV-negative syphilis patients with complete information of treatment and regular follow-up in the dermatology department of Shengjing Hospital of China Medical University from August 2012 to July 2022 were collected,sorted and retrospectively analyzed.Patients with early syphilis were followed up for 1 year and late syphilis were followed up for 2 years.The factors were analyzed by multivariate Logistic regression analysis.2.Study on the outcome of retreatment of syphilis serofast:Patients with serofast after initial treatment and follow-up records of more than 1 year were divided into treatment group(retreatment with benzathine penicillin)and control group(no retreatment).The efficacy of retreatment was analyzed by chi-square test.Results:1.Clinical data:A total of 525 syphilis patients with complete information were enrolled,including 173 males(32.95%)and 352 females(67.05%).The age ranged from 15 to 81 years(mean 29 years).There were 80 primary syphilis(15.24%),151 secondary syphilis(28.76%),294 latent syphilis(56%),including 199 early latent syphilis(37.90%)and 95 late latent syphilis(18.10%).There were 266 serofast patients after initial treatment,and the rate of serofast was 50.67%.Chi-square test showed that disease stage and genders have significant difference(P<0.001),and the proportion of latent syphilis in female was higher.There was significant difference in disease stages among different age(P<0.001).The proportion of latent syphilis was higher in the elderly.2.Influencing factors of serofast:Multivariate Logistic regression analysis showed that latent syphilis and RPR initial titer ≥1:32 were risk factors(early latent syphilis OR=4.780,95%CI:2.496～9.153,P<0.05;late latent syphilis OR=8.464,95%CI:3.963～18.077,P<0.05;RPR initial titer was 1:32 OR=5.896,95%CI:2.520～13.796,P<0.05;the initial titer was 1:64 OR=5.229,95%CI:1.864～14.672,P<0.05;the initial titer was 1:128 OR=36.737,95%CI:6.494～207.826,P<0.05).The risk of serofast was low in males(OR=0.647,95%CI:0.421～0.993,P<0.05).There was no significant difference between three or more doses of benzathine penicillin,immunomodulator,age and serofast patients(P>0.05).3.Analysis of the value of retreatment with benzathine penicillin in serofast:A total of 222 patients were enrolled in the second stage,of which 92(41.44%)were retreated and 19(20.65%)achieved serological cured.130(58.56%)were unretreated,and 26(20.00%)achieved serological cured.Chi-square test showed that there was no significant difference between retreatment and unretreatment in serofast patients(P>0.05).Conclusion:1.Female patients are more than male patients with latent syphilis,and the elderly are more likely to develop latent syphilis than young people.2.The incidence of serofast in syphilis patients after treatment is high,especially in women,latent syphilis and those with higher initial titer of RPR.Age and immunomodulators have no relationship with serofast,and the application of more than three doses of benzathine penicillin in initial treatment cannot reduce the serofast.3.The rate of serofas did not improve significantly for patients who received retreatment with benzathine penicillin.