CAJ | 학술논문

　　目的了解重庆铁路辖区内离退休老年（≥60岁）男性性传播疾病（STD）混合感染者的临床特征，分析影响老年男性STD混合感染的相关因素，为辖区内老年男性STD的防治提供参考依据。方法对2009～2012年间在重庆市第十三人民医院皮肤性病科门诊就诊的432例老年（≥60岁）男性STD患者进行检测，将检测到的48例混合感染作为调查研究对象，制作老年STD混合感染的流行病学及临床调查表，依据患者病原体检测、问诊查体、治疗预后以及睾酮水平检测等方面的结果填写相关项目。结果432例老年男性STD患者检测病原体，48例为混合感染，占11．1％。老年男性STD混合感染有6种病原体：沙眼衣原体、淋病奈瑟菌、梅毒螺旋体、人类免疫缺陷病毒、人类乳头瘤病毒及疑似杜克雷嗜血杆菌；有10种组合模式，以沙眼衣原体加人类乳头瘤病毒和淋病奈瑟菌加人类乳头瘤病毒混合感染最为常见，分别占27．1％和20．8％；首诊症候群首位为阴部疣状物加尿路症状（28例），其次为阴部丘疹破溃加尿路症状（6例）。采用最优的综合治疗后1个月仅治愈6例，2个月治愈7例，3个月治愈11例，治愈率为50％；血清睾酮水平：观察组为（14．7±5．8）mmol/L ，健康对照组为（10．3±5．6）mmol/L ，观察组血清睾酮水平高于对照组，两组比较差异有统计学意义（t＝3．41，P＜0．05）。结论老年人群STD混合感染并不少见。治疗疗程长、疗效低及婚外性行为、较高的血清睾酮水平是导致老年STD及混合感染发生的主要原因。
　　목적료해중경철로할구내리퇴휴노년（≥60세）남성성전파질병（STD）혼합감염자적림상특정，분석영향노년남성STD혼합감염적상관인소，위할구내노년남성STD적방치제공삼고의거。방법대2009～2012년간재중경시제십삼인민의원피부성병과문진취진적432례노년（≥60세）남성STD환자진행검측，장검측도적48례혼합감염작위조사연구대상，제작노년STD혼합감염적류행병학급림상조사표，의거환자병원체검측、문진사체、치료예후이급고동수평검측등방면적결과전사상관항목。결과432례노년남성STD환자검측병원체，48례위혼합감염，점11．1％。노년남성STD혼합감염유6충병원체：사안의원체、임병내슬균、매독라선체、인류면역결함병독、인류유두류병독급의사두극뢰기혈간균；유10충조합모식，이사안의원체가인류유두류병독화임병내슬균가인류유두류병독혼합감염최위상견，분별점27．1％화20．8％；수진증후군수위위음부우상물가뇨로증상（28례），기차위음부구진파궤가뇨로증상（6례）。채용최우적종합치료후1개월부치유6례，2개월치유7례，3개월치유11례，치유솔위50％；혈청고동수평：관찰조위（14．7±5．8）mmol/L ，건강대조조위（10．3±5．6）mmol/L ，관찰조혈청고동수평고우대조조，량조비교차이유통계학의의（t＝3．41，P＜0．05）。결론노년인군STD혼합감염병불소견。치료료정장、료효저급혼외성행위、교고적혈청고동수평시도치노년STD급혼합감염발생적주요원인。
Objective To understand clinical features of sexually transmitted diseases (STD) mixed infection a-mong retired and elderly (≥60 years old)males in the area of Chongqing railway and analyze relevant factors to pro-vide a reference for the prevention and treatment .Methods 432 elderly male patients in Outpatient Departments of Kin and Venereal Disease in the 13th People′s Hospital of Chongqing City from 2009-2012 were detected ,48 cases of mixed infections were detected and as research objects .The epidemiology and clinical questionnaire for elderly STD mixed infection were made .Items were filled based on pathogen detection ,inquiry body ,treatment prognosis and tes-tosterone levels .Results Pathogens of 432 elderly male STD were detected ,and 48 cases were mixed infections ,ac-counting for 11 .1% .Elderly male STD mixed infection had 6 types of pathogens :chlamydia trachomatis ,neisseria gonorrhoeae ,treponema pallidum ,human immunodeficiency virus ,human popilloma virus ,suspected haemophilus du-creyi ,with 10 kinds of combination modes ,most of which were mixed infection of chlamydia trachomatis and human popilloma virus ,neisseria gonorrhoeae and human popilloma virus ,accounting for 27 .15% and 20 .8% respectively . The first diagnosis of syndrome was genital ware like and urinary symptoms (28 cases) ,followed by pudenda popular ruptured and urinary symptoms (6 cases) .6 cases were cured after 1 month of optimal comprehensive treatment ,7 cases were cured after 2 months ,11 cases were cured after 3 months ,and the cure rate was 50% .Serum testosterone level of observation group was (14 .7 ± 5 .8)mmol/L ,that of healthy control group was (10 .3 ± 5 .1)mmol/L ,and se-rum testosterone level of observation groups was significantiy higher than healthy control group (t= 3 .41 ,P<0 .05) .Conclusion Elderly STD mixed inflections might not be uncommon .Longer treatment regimens ,lower cura-tive effect ,sex outside marriage and high levels of serum testosterone could be the main reasons .