冉景林　申莉梅　郑敏

摘要：目的 调查贵州省梅毒报告疫情变化的影响因素，揭示真实的疫情变化，为改进梅毒的诊断和疫情报告工作提供依据。方法 在贵州省九个市（州）40个县（市、区）中选取61家医疗机构进行问卷调查，应用SPSS 19.0软件进行分析。结果 贵州省梅毒病例报告数逐年迅速上升的主要原因在于筛查数量的增加和医疗机构医务人员缺乏对梅毒诊断标准的掌握，在临床诊疗中把较多不符合梅毒诊断标准的病例错误报告、过度报告。结论 加强对相关医疗机构医生的培训，使其掌握诊断标准，准确报病，减少重报和过度报告，切实落实梅毒相关疫情管理制度，是规范贵州省梅毒诊断和疫情报告的重点。

关键词：梅毒；报告疫情；影响因素

Abstract：Objective Research on the influential factors of the changes in the reported epidemic situation of syphilis in Guizhou Province and reveal the syphilis epidemic situation changes in reality so as to lay basis for the future improvement of syphilis diagnosis and epidemic situation report.Methods Select 61 medical institutions from 40 counties（cities and districts）in 9 cities（prefectures）of Guizhou Province to take on a questionnaire survey and analyze the results by SPSS19.0.Results The increase of people being examined and the relatively large number of wrongly reported cases in clinical practices due to medical staff's lack of knowledge of syphilis diagnosis standards have resulted in the rapid increase in reported syphilis patients in Guizhou in recent years.Conclusion In order to improve the syphilis diagnosis and epidemic situation report in Guizhou，focus should be placed on both the implementation of the syphilis epidemic management policies and rules and reinforcing the training of medical staff，enabling them to master the diagnosis standards and accurately report confirmed cases.Thus the repeatedly reported cases will be reduced.

Key words：Syphilis；reported epidemic situation；Influential factors

梅毒是蒼白密螺旋体苍白亚种引起的性传播疾病，其临床表现多样、病程慢性发展、可导致系统性的病变[1-2]，是我国法定报告传染病及重点监测的疾病之一[3]。近10余年来，全国梅毒疫情呈快速上升趋势，贵州省梅毒疫情近年来增幅较 大[4]。为了解梅毒疫情上升因素，揭示真实的疫情变化，根据中国疾病预防控制中心性病预防控制中心制定的《性病疫情变化影响因素调查方案》和调查问卷[5]，贵州省疾病预防控制中心在全省九个市（州）选取了2014年梅毒报告病例数在100例以上，且I期梅毒报告病例数在30例以上的40个县（市、区），在以上县（市、区）选择设有正式挂牌的皮肤性病科（包括皮肤科、性病科、皮肤性病科）的61家二级乙等及以上医疗机构进行问卷调查，分析影响梅毒疫情变化的因素。……