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How to determine whether the cure syphilis

Updated: Tuesday, Nov 10,2009, 4:00:25 PM
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Syphilis after treatment, how to determine whether the cure out? Now usually with syphilis serology tests to be judged, at present more commonly used in major hospitals is RPR (rapid plasma reagin test) and TPHA (Treponema pallidum hemagglutination test).

Non-specific syphilis serology tests, commonly used in the early diagnosis of syphilis, but for latent syphilis, neurosyphilis is not sensitive. TPHA serum specific Treponema pallidum antibodies, have high sensitivity and specificity. Once the positive detection of this Act, regardless of whether the treatment or not, or disease activity, often enjoyed the positive constant, its titer change and whether the activities of syphilis has nothing to do, it can not be determined for evaluating the effectiveness of treatment or relapse and re-infection of target can only be as syphilis confirmation test.

Where a person diagnosed with syphilis before treatment is best to do quantitative test. Changes in the two quantitative test titer dilution difference between the two above, can determine the titer decreased. Formal treatment of syphilis patients after the first three months should be reviewed once a month RPR titer, and the rest can be changed once every three months to review the RPR, the second year review every three months or once every six months RPR, in order to observation and comparison with previous times when the RPR titer of changing circumstances. Therefore, syphilis patients after treatment follow-up observation of generally two years. If each of the RPR titer test showed declining trend shows that the treatment is effective against plum. If three to four consecutive test results are negative, then it could be considered in patients with syphilis had been cured.

Syphilis patients after treatment of anti-mei, the serum response to changes in general there are three kinds of possibilities:

(1) serum overcast.

(2) lower serum titers are not overcast, or serum resistance.

(3) The serum response showed recurrence.

To accept different stages of syphilis, drug treatment, sero-negative conversion rate can make a difference. Early syphilis accept any anti-mei drug therapy, serum negative rate are high, usually one year up to 70% to 95%, isolated reports of up to 100%. When the regular anti-mei early syphilis after treatment for 6 months, or late syphilis, the regular anti-mei 12 months after treatment, serum response remained positive, clinically known as serum resistance or serum is fixed, can occur because there is still potential in vivo of active lesions in patients with persistent immunity against plum or a lack of therapeutic dose of drug resistance and other factors. Three substantive neurosyphilis syphilis (eg, spinal tuberculosis, paralytic dementia), even if the long-term anti-plum formal treatment, there are still 50% to 80% of patients will occur in serum resistance. Early diagnosis, early treatment, foot treatment is to avoid the best means of serum resistance.

If the syphilis patients received less than the amount of anti-mei treatment, sero-negative conversion in shortly after being turned to positive, or 4-fold titer increase (eg, from 1:2 up to 1:8), namely that the "Serum recurrence," Clearly, the anti-plum treatment whether or not formal enough and there is a close relationship between serum recurrence.

In conclusion, early syphilis treatment should be formal enough, RPR titer can be observed before and after the therapeutic effect of anti-mei.

Tags: syphilis

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