| Objective:To investigate the epidemiological characteristics and related factors impacting the prognosis of syphilis of STD clinic syphilis patients in our hospital, which provide the basis for the prevention and treatment of syphilis.Methods:The objects of this study were the STD clinic syphilis patients during the period from January 2009 to December 2013 in the First Affiliated Hospital of Kunming Medical University. Collecting their epidemiological characteristics and clinical features, conducting TPPA and TRUST titer, and then staging diagnosis of syphilis for TPPA and TRUST were both positive patients, collecting their vein blood for testing HIV and HSV-2 antibodies at the same time. The data were input to the Excel database and analysised the related factors affecting prognosis of syphilis after standard treatment in patients with complete follow-up data for more than 2 years by SPSS 19.0 statistical software.Results:A total of 1755 cases for TPPA and TRUST were both positive.(1)Of 1755 cases male patients were 695 cases while female patients were 1060 cases, male to female ratio was 0.66:1. Age of patients were 16 to 86 years old with an average of 34.2 years old.16 to 39-year-old groups were the most cases. Each education level were distributed, mainly based in junior high school and below(54.9%). Occupation distributed in all walks of life, among which the unemployed accounted for 32.6%, followed by company employees(20.2%). (2) The proportion of the unmarried, married, divorced or widowed were 83.8%,13.9% and 2.3% respectively.98.8% of the patients were heterosexual transmission. Only 4.6% of patients insist on the use of condom. In unmarried group, people who never using condoms were 6.4%,20.2%, and 20.7%, while in married/divorced/widowed group the rates were 90.1%,41.1% and 32.7% when number of sexual partners were one, two, greater than or equal to 3. (3) 91.5% of the patients were Han pepole.53.3% of the patients’main cause of visit was physical examination, followed by the lesions and related damage to internal organs(15.2%), other preoperative hospitalization(14.6%), pre-pregnancy and pregnancy check (13.0%). (4)Clinical manifestations of primary syphilis were chancre, secondary syphilis had a variety of skin lesions, clinical manifestations, and oral syphilitic swollen gums were the two cases’clinical manifestations of tertiary syphilis. (5)The rate of syphilis and HIV, syphilis and genital herpes co-infection was 1.0% and 5.3%.A total of 335 cases for complete follow-up data for more than 2 years. (1) TRUST total negative rate was of 91.6%, including a negative rate of 100% of primary syphilis, significantly higher than 94.1% of secondary syphilis and 90.9% of latent syphilis. One case of tertiary syphilis was not negative. The early syphilis with initial serum titer≥1:32 were all negative before treatment, significantly higher than the patients with initial serum titer<1:32.93.0% of Han patients’TRUST titer became negative, which significantly higher than 79.4% negative rate of other minority. (7) After 2-year follow,13 cases appeared TRUST relapse. The serorelapse rate was 3.9% in total, of which primary syphilis’relapse rate was 0%, secondary syphilis’relapse rate was 5.9%, latent syphilis’relapse rate was 3.3%, and one case of tertiary syphilis without relapse.16.7% of patients combined with HIV and genital herpes occured serorelapse, which significantly higher than 3.2% serorelapse rate of combined with other sexually transmitted diseases.16.9% of patients before treatment with 1:1 of TRUST initial titer occured serorelapse, which significantly higher than≥ 1:2 patients’serorelapse rate of 2.4%.33.3% of homosexual patients occured serorelapse, which significantly higher than non-homosexual patients’serorelapse rate of 3.6%. Among patients who went to hospital actively,28.6% with the reason of premarital check and 25.0% with the reason of pre-pregnancy check had higher serorelapse rate than those serorelapse rate of 3.1% with other causes of treatment. (8) The serofixation rate was 4.5% in total, of which primary syphilis’serofixation rate was 0%, secondary syphilis’serofixation rate was 0%, latent syphilis’rserofixation rate was 5.8%, and the only tertiary syphilis occured serofixed. The serofixation rate of Benzathine Penicillin G was 3.3%, which significantly lower than other drugs’ serofixation rate of 17.2%.11.8% of minority patients occured serofixed, which significantly higher than the Han patients’serofixation rate of 3.7%.Conclusion:The STD clinic syphilis patients visits throughout all ages, all education levels, all walks of life. Multiple sexual partners and low use of condom were important risk factors of syphilis infection. Sexual partners’simultaneous check and treatment were extremelly essential. Multi-levels, multi-channels, multi-modes and multi-covered groups of STD prevention education should be further strengthened. Young adult, low educational level and low-income populations need to be focused on well. Early detection, early diagnosis and early treatment were important measures to improve the cure rate of syphilis and avoid the appearance of serofixation and serorelapse. Combined with other sexually transmitted diseases was an important risk factor of syphilis serorelapse. Benzathine Penicillin G was still the best choice for the treatment of syphilis.
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