What does the treatment method of syphilis nephropathy have?

The transmission and pathogenesis of syphilis is characterized by periodic latent and recurrent syphilis bdsm chastity , which is related to the production of immunity. When the immunity of the body decreases, Treponema pallidum can invade some parts of the body. Syphilis-associated nephropathy mainly occurs in acquired secondary syphilis, and its incidence is low. The clinical manifestations of acquired syphilis renal damage are varied, such as acute nephrotic syndrome, membranous glomerulonephritis, acute progressive glomerulonephritis and so on rose vibrator , but the incidence of the latter is not high. However, syphilis tests should be performed routinely in patients with newly developed nephrotic syndrome to rule out the possibility of syphilis. So, what is the treatment of syphilis nephropathy?

The disease is mainly aimed at the treatment of syphilis, in the treatment of the primary disease at the same time the corresponding symptomatic treatment of kidney disease.

one. Early syphilis

Including primary and secondary syphilis and latent syphilis with a disease period of less than 2 years. Effective anti-spirochete drugs should be selected to eliminate the living spirochetes in the body, so as to make the lesions lose infectivity in the shortest time, so as not to infect others, and make the body repair tissue damage as soon as possible to promote the rapid healing of lesions. Early syphilis can be completely cured if treated in time, and can prevent further development and deterioration of pathological changes and clinical symptoms, and protect vital organs of the human body.

(1) penicillins: benzylpenicillin is the first choice. If there is no penicillin, penicillin can also be used as an alternative drug. The common dose of benzylpenicillin was 2.4 million U, intramuscularly injected on both sides of gluteus once a week, twice a week, APPG 800000 U / day, intramuscular injection for 15 consecutive days, total amount 8 million ~ 1200 million U, water agent penicillin G 1.2 million unit, intramuscular injection, 3 times a day, continuous 20 days, total amount 36 million ~ 7200 million U.

(2) the following drugs were used for patients with penicillin hypersensitivity: tetracycline hydrochloride 0.5g, oral, 4 times a day for 15 days (forbidden in patients with liver and kidney insufficiency), erythromycin, 0.1g doxycycline (doxycycline) 0.1g, oral, twice a day for 15 days.

two. Late syphilis

Including advanced skin, mucous membrane, bone and joint syphilis, the disease period of more than 2 years or can not determine the stage of latent syphilis. Late syphilis is destructive to various tissues and organs of the body, so it is necessary to cure the lesions, promote the body to repair tissue trauma, and prevent the progression and loss of function of important organs. Late syphilis can appear some injuries that can not be completely repaired, such as pharynx, nose defects, bone deformities and so on. Orthopedic surgery can correct some deformities and disabilities and restore part or all of the function.

(1) penicillins: benzylpenicillin is preferred, or water agent penicillin is used as an alternative drug. Benzylpenicillin 2.4 million U, intramuscular injection, once a week, a total of 3 times. APPG 800000 U / d was injected intramuscularly for 20 days as a course of treatment with a course of 1600 million U. The second course of treatment, with a total amount of 3200 million units, can also be considered. The drug was stopped for 2 weeks during the course of treatment. The water agent penicillin G 1.2 million U was injected intramuscularly 3 times a day for 20 days as a course of treatment, with a course of 7200 million U. The second course of treatment, with a total amount of 14400 million units, can also be considered. The drug was stopped for 2 weeks during the course of treatment.

(2) for patients with penicillin allergy, the following drugs were selected: tetracycline hydrochloride 0.5g/ times, oral, 4 times a day, 30 days as a course of treatment, the course of treatment was 60.0g. Erythromycin is the same as tetracycline. Doxycycline (doxycycline) 0.1 g, orally, twice a day for 30 days.

three. Treatment of cardiovascular syphilis

Benzylpenicillin is prohibited. If there is heart failure or arrhythmia, the use of drugs to correct, until the cardiac function can be compensated, heart rhythm returned to normal lockthecock , and then treated with plum expelling. And should start from a small dose, gradually increase the dose, so as not to occur JmurH reaction, resulting in aggravation of the disease or death of patients. Penicillin G, a common water agent, was injected intramuscularly on the first day, 10 million U on the second day, twice a day on the second day, and 200000 U on the third day, twice a day. From the 4th day, the patients were treated with the following regimens: APPG 800000 U / day, intramuscular injection, continuous 15 days as a course of treatment, the course of treatment was 1200 million units, with a total of 2 courses or more. The drug was stopped for 2 weeks during the course of treatment. For patients with penicillin allergy, the following drugs were selected: tetracycline hydrochloride 0.5g, orally, 4 times a day, for 30 days as a course of treatment, 60 g; erythromycin, the same as tetracycline.

four. Treatment of neurosyphilis

The main results were as follows: (1) 2 million ~ 4 million U of penicillin G was given intravenously every 4 hours for 10 days. Then 2.4 million units of benzylpenicillin were injected intramuscularly for 3 weeks.

(2) APPG 2.4 million U pare d, intramuscular injection, and oral administration of 0.5 g probenecid 4 times a day for 14 consecutive days. Then 2.4 million units of benzylpenicillin were injected intramuscularly for 3 weeks.

(3) for patients with penicillin allergy, tetracycline hydrochloride 0.5g orally, 4 times a day, for 30 days as a course of treatment, the treatment course dose is 60g.

five. The treatment of gestational syphilis should not only treat the early or late syphilis of pregnant women, but also prevent the occurrence of fetal syphilis; once fetal syphilis occurs, the fetus can be cured before birth.

(1) APPG 800000 U / d was injected intramuscularly for 10 days as a course of treatment, with a course of 8 million U. One course of injection was given in the first 3 months of pregnancy and one course of injection in the third month of pregnancy.

(2) the water agent penicillin G 1.2 million U was injected intramuscularly 3 times a day for 20 consecutive days as a course of treatment with a course of 7200 million U. One course of injection was given in the first 3 months of pregnancy and one course of injection in the third month of pregnancy.

(3) Erythromycin is used to treat patients with penicillin allergy, tetracycline is prohibited. The usage and dosage are the same as those of non-pregnant patients, but their babies are treated with penicillin.

(4) there is a clear record of having received adequate treatment in the past, but now there is no recurrence, no reinfection, but no treatment.

six. Treatment of fetal syphilis

(1) early fetal syphilis:

① cerebrospinal fluid abnormality: APPG 50000 U / (kg? D), intramuscular injection for 14 consecutive days, or water agent penicillin G 50000 U / (kg? D), intravenous drip twice for 10 to 14 days.

Patients with normal cerebrospinal fluid (②): benzylpenicillin 50000 U / kg, intramuscular injection. Not for those with neurosyphilis damage.

③ unconditional examination of cerebrospinal fluid: can be treated according to abnormal cerebrospinal fluid.

④ allergic to penicillin: treated with erythromycin with a dose of 7.5~12.5mg/ (kg? D), taken orally for 4 times for 15 days. Disable tetracycline.

(2) late fetal syphilis:

① APPG 50000 U / (kg? D), intramuscular injection for 10 days as a course of treatment. The amount of penicillin used in older children should not exceed the amount of treatment for adults in the same period.

Patients with penicillin allergy to ② were treated with erythromycin or tetracycline at a dose of 7.5~12.5mg/ (kg? D), taken orally for 4 times for 30 days. Tetracycline is prohibited in children under 8 years of age.

seven. Syphilis nephropathy is treated with reference to other nephrotic syndrome and glomerulonephritis.
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