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Article(id=1324050889077564254, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202510106, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760025600000, receivedDateStr=2025-10-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607931632, onlineDateStr=2026-11-02, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607931632, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607931632, creator=13701087609, updateTime=1793607931632, updator=13701087609, issue=Issue{id=1324050669933572771, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607879384, creator='13701087609', updateTime=1793670100562, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311644528050975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311644528050976, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1704, endPage=1709, ext={EN=ArticleExt(id=1324050889262113631, articleId=1324050889077564254, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics of syphilis among people aged 60 years and above in Hebei Province from 2015 to 2024, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the epidemiological characteristics of syphilis among people aged 60 years and above in Hebei Province from 2015 to 2024, and to provide a basis for formulating prevention and control strategies.

Methods

Data on syphilis cases reported in Hebei Province from 2015 to 2024 were collected through the Chinese Disease Prevention and Control Information System, and descriptive epidemiological methods were used for analysis.

Results

The number of syphilis cases reported among people aged 60 and above in Hebei Province increased from 2 261 to 3 570, and the reported incidence rate rose from 21.32 per 100 000 to 22.19 per 100 000. The reported incidence rate of primary syphilis showed a downward trend, while that of secondary syphilis showed an initial increase followed by a decrease. The reported incidence rate of tertiary syphilis did not show a linear trend change. The number of reported cases of latent syphilis showed an upward trend. The proportion of primary and secondary syphilis decreased from 26.54% to 6.00%, while the proportion of latent syphilis cases increased from 72.76% to 93.56%. During the ten years, the number of reported cases and the incidence rate among men were higher than those among women each year. The highest average annual incidence rate was observed in the age group of 85 years and older (34.19 per 100 000 population).

Conclusion

The number of syphilis cases reported among people aged 60 and above in Hebei Province has been increasing year by year from 2015 to 2024, with a high proportion of latent syphilis showing an upward trend. This suggests that we should further pay attention to the sexual health of the elderly, and implement targeted prevention and control measures based on their disease characteristics.

, authors=Ya-li ZHANG1, Jing-qiu WANG1, Yan ZHANG2, Xin-li LU1, Wei WANG1, Xiao-ying CHENG1, authorsList=Ya-li ZHANG, Jing-qiu WANG, Yan ZHANG, Xin-li LU, Wei WANG, Xiao-ying CHENG, authorCompany=null, correspAuthors=Jing-qiu WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050889840927586, articleId=1324050889077564254, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2015—2024年河北省≥60岁人群梅毒流行特征分析, columnId=1228016573844226129, journalTitle=现代预防医学, columnName=疾病预防控制, runingTitle=null, highlight=null, articleAbstract=
目的

了解2015—2024年河北省≥60岁人群梅毒流行特点，为制订防控策略提供依据。

方法

通过中国疾病预防控制信息系统收集2015—2024年河北省梅毒报告数据，应用描述流行病学方法进行分析。

结果

2015—2024年河北省≥60岁人群梅毒报告病例数由2 261例上升至3 570例，梅毒报告发病率由21.32/10万上升至22.19/10万。一期梅毒报告发病率呈下降趋势，二期梅毒报告发病率呈先上升后下降趋势，三期梅毒报告发病率未见线性趋势变化，隐性梅毒报告病例数呈上升趋势。一期梅毒和二期梅毒所占比例由26.54%下降至6.00%，隐性梅毒病例所占比例由72.76%增加至93.56%。十年间，每年男性报告病例数和发病率均高于女性。年均发病率最高的是85岁及以上年龄组（34.19/10万）。

结论

2015—2024年河北省≥60岁人群梅毒报告病例数逐年增加，隐性梅毒所占比例高，呈现上升趋势，提示我们应进一步加强关注老年人性健康，结合其疾病特点，落实针对性防控措施。

, authors=张亚丽1, 王敬丘1, 张岩2, 路新利1, 王伟1, 成效莹1, authorsList=张亚丽, 王敬丘, 张岩, 路新利, 王伟, 成效莹, authorCompany=null, correspAuthors=王敬丘, authorNote=

张亚丽（1978—），女，硕士，副主任技师，研究方向: 性病艾滋病宣传教育与干预

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王敬丘，E-mail：
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张亚丽（1978—），女，硕士，副主任技师，研究方向: 性病艾滋病宣传教育与干预

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张亚丽（1978—），女，硕士，副主任技师，研究方向: 性病艾滋病宣传教育与干预

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Investig Clin Urol, 2019, 60(3): 202-209., articleTitle=Sexual behavior and sexually transmitted infection in the elderly population of South Korea, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1324050890063225699, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, xref=1., ext=[AuthorCompanyExt(id=1324050890067420004, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, companyId=1324050890063225699, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute for AIDS/STD Control and Prevention, Hebei Province Center for Disease Control and Prevention, Shijiazhuang, Hebei 050021, China), AuthorCompanyExt(id=1324050890080002917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, companyId=1324050890063225699, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.河北省疾病预防控制中心性病艾滋病防治所，河北 石家庄 050021)]), AuthorCompany(id=1324050890155500390, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, xref=2., ext=[AuthorCompanyExt(id=1324050890163888999, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, companyId=1324050890155500390, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.石家庄市桥西区汇通华城社区卫生服务站)])], figs=[ArticleFig(id=1324050896715391885, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=EN, label=Figure 1, caption=Trend in reported syphilis incidence rate among adults aged ≥60 years in Hebei Province, 2015—2024, figureFileSmall=SK+gKg9iX4hTH4Nsz3oXTA==, figureFileBig=59F9hKc1/Pr3JCcK6gGrEw==, tableContent=null), ArticleFig(id=1324050896828638094, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=CN, label=图1, caption=河北省2015—2024年≥60岁人群梅毒报告发病率变化情况, figureFileSmall=SK+gKg9iX4hTH4Nsz3oXTA==, figureFileBig=59F9hKc1/Pr3JCcK6gGrEw==, tableContent=null), ArticleFig(id=1324050897172571023, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=EN, label=Table 1, caption=

Number of reported syphilis cases and incidence rate (per 100 000 population) by stage among adults aged ≥60 years in Hebei Province, 2015—2024

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）Ⅰ期梅毒Ⅱ期梅毒III期梅毒隐性梅毒合计
病例数
（发病率）		构成比（%）病例数
（发病率）		构成比（%）病例数
（发病率）		构成比（%）病例数
（发病率）		构成比（%）病例数
（发病率）
2015409（3.86）18.09191（1.80）8.4516（0.15）0.711 645（15.51）72.762 261（21.32）
2016364（3.19）16.11180（1.58）7.9632（0.28）1.421 684（14.74）74.512 260（19.79）
2017437（3.71）16.78207（1.76）7.9527（0.23）1.041 934（16.42）74.242 605（22.12）
2018472（3.75）15.38313（2.49）10.2023（0.18）0.752 261（17.98）73.673 069（24.41）
2019317（2.21）9.78287（2.00）8.8623（0.16）0.712 613（18.19）80.653 240（22.56）
2020259（1.77）8.93234（1.60）8.0728（0.19）0.972 379（16.22）82.032 900（19.77）
2021227（1.53）7.57147（0.99）4.9016（0.11）0.532 608（17.61）86.992 998（20.24）
2022162（1.09）7.6287（0.59）4.099（0.06）0.421 869（12.62）87.872 127（14.36）
2023143（0.94）4.87105（0.69）3.5816（0.11）0.552 671（17.55）91.012 935（19.29）
2024143（0.89）4.0171（0.44）1.9916（0.10）0.453 340（20.76）93.563 570（22.19）
), ArticleFig(id=1324050897298400144, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=CN, label=表1, caption=

河北省2015—2024年≥60岁人群梅毒分期报告病例数和发病率（1/10万）

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）Ⅰ期梅毒Ⅱ期梅毒III期梅毒隐性梅毒合计
病例数
（发病率）		构成比（%）病例数
（发病率）		构成比（%）病例数
（发病率）		构成比（%）病例数
（发病率）		构成比（%）病例数
（发病率）
2015409（3.86）18.09191（1.80）8.4516（0.15）0.711 645（15.51）72.762 261（21.32）
2016364（3.19）16.11180（1.58）7.9632（0.28）1.421 684（14.74）74.512 260（19.79）
2017437（3.71）16.78207（1.76）7.9527（0.23）1.041 934（16.42）74.242 605（22.12）
2018472（3.75）15.38313（2.49）10.2023（0.18）0.752 261（17.98）73.673 069（24.41）
2019317（2.21）9.78287（2.00）8.8623（0.16）0.712 613（18.19）80.653 240（22.56）
2020259（1.77）8.93234（1.60）8.0728（0.19）0.972 379（16.22）82.032 900（19.77）
2021227（1.53）7.57147（0.99）4.9016（0.11）0.532 608（17.61）86.992 998（20.24）
2022162（1.09）7.6287（0.59）4.099（0.06）0.421 869（12.62）87.872 127（14.36）
2023143（0.94）4.87105（0.69）3.5816（0.11）0.552 671（17.55）91.012 935（19.29）
2024143（0.89）4.0171（0.44）1.9916（0.10）0.453 340（20.76）93.563 570（22.19）
), ArticleFig(id=1324050897466172305, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=EN, label=Table 2, caption=

Number of reported syphilis cases and incidence rate(per 100 000 population) by gender among adults aged ≥60 years in Hebei Province, 2015—2024

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）男性病例数
（发病率）		女性病例数
（发病率）		男女性别比
（发病率）
20151 313（25.34）948（17.47）1.45
20161 332（23.71）928（15.99）1.48
20171 512（26.68）1 093（17.89）1.49
20181 778（29.67）1 291（19.62）1.51
20191 889（27.35）1 351（18.11）1.51
20201 684（23.99）1 216（15.90）1.51
20211 734（24.57）1 264（16.30）1.51
20221 237（17.74）890（11.35）1.56
20231 678（23.53）1 257（15.54）1.51
20241 989（26.42）1 581（18.47）1.43
), ArticleFig(id=1324050897550058386, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=CN, label=表2, caption=

河北省2015—2024年≥60岁人群梅毒按性别报告病例数和发病率（1/10万）

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）男性病例数
（发病率）		女性病例数
（发病率）		男女性别比
（发病率）
20151 313（25.34）948（17.47）1.45
20161 332（23.71）928（15.99）1.48
20171 512（26.68）1 093（17.89）1.49
20181 778（29.67）1 291（19.62）1.51
20191 889（27.35）1 351（18.11）1.51
20201 684（23.99）1 216（15.90）1.51
20211 734（24.57）1 264（16.30）1.51
20221 237（17.74）890（11.35）1.56
20231 678（23.53）1 257（15.54）1.51
20241 989（26.42）1 581（18.47）1.43
), ArticleFig(id=1324050897663304595, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=EN, label=Table 3, caption=

Number of reported syphilis cases and incidence rate (per 100 000 population) by age group among adults aged ≥60 years in Hebei Province, 2015—2024

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段（岁）2015年2016年2017年2018年2019年2020年2021年2022年2023年2024年
60～64608（14.32）570（13.53）627(15.02)720(17.50)737(15.42)595(13.23)597(13.49）333（8.35）534（13.64）683（15.57）
65～69550（24.52）611（24.05）713(26.61)776(26.02)865(20.21)766(17.38)727(16.74）506（11.38）644（14.25）712（15.74）
70～74379（22.95）426（22.74）501(25.41)606(27.62)715(31.42)719(27.59)757(28.46）541（17.75）767（23.32）895（25.50）
75～79320（24.76）301（20.53）366(23.72)411(23.93)432(28.23)414(26.11)515(31.77）411（24.43）509（27.88）707（35.79）
80～84212（26.90）188（21.05）213(22.59)318(30.28)275(27.13)232(24.65)239(22.64）212（22.17）288（29.74）371（37.91）
85及以上192（49.75）164（37.57）185(40.00)238(46.15)216(44.40)174(27.56)163(23.03）124（17.95）193（27.40）202（28.06）
合计2 261（21.32）2 260（19.79)2 605(22.12)3 069(24.41)3 240(22.56)2 900(19.77)2 998（20.24）2 127（14.36）2 935（19.29）3 570（22.19）
), ArticleFig(id=1324050897814299540, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050889077564254, language=CN, label=表3, caption=

河北省2015—2024年≥60岁人群梅毒按年龄段报告病例数和发病率（1/10万）

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段（岁）2015年2016年2017年2018年2019年2020年2021年2022年2023年2024年
60～64608（14.32）570（13.53）627(15.02)720(17.50)737(15.42)595(13.23)597(13.49）333（8.35）534（13.64）683（15.57）
65～69550（24.52）611（24.05）713(26.61)776(26.02)865(20.21)766(17.38)727(16.74）506（11.38）644（14.25）712（15.74）
70～74379（22.95）426（22.74）501(25.41)606(27.62)715(31.42)719(27.59)757(28.46）541（17.75）767（23.32）895（25.50）
75～79320（24.76）301（20.53）366(23.72)411(23.93)432(28.23)414(26.11)515(31.77）411（24.43）509（27.88）707（35.79）
80～84212（26.90）188（21.05）213(22.59)318(30.28)275(27.13)232(24.65)239(22.64）212（22.17）288（29.74）371（37.91）
85及以上192（49.75）164（37.57）185(40.00)238(46.15)216(44.40)174(27.56)163(23.03）124（17.95）193（27.40）202（28.06）
合计2 261（21.32）2 260（19.79)2 605(22.12)3 069(24.41)3 240(22.56)2 900(19.77)2 998（20.24）2 127（14.36）2 935（19.29）3 570（22.19）
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Reported syphilis incidence rate (per 100 000 population) by region among adults aged ≥60 years in Hebei Province, 2015—2024

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地区2015年2016年2017年2018年2019年2020年2021年2022年2023年2024年
石家庄市27.7424.9823.1924.7425.5016.9520.6815.6817.9317.72
唐山市24.1319.2917.2018.5919.2918.7122.6112.3420.7518.60
秦皇岛市17.9221.3326.0728.3836.8036.5222.7920.1631.6331.70
邯郸市11.6312.9513.8419.6517.9519.8617.8313.3011.9715.26
邢台市16.8512.2816.5120.7521.4327.9726.1921.2923.7732.06
保定市15.0617.5922.8220.6814.1812.3912.378.3111.7218.66
张家口市34.5127.6731.5549.7143.5835.8535.3721.3733.4237.59
承德市47.5134.3340.3641.2928.4721.3216.6715.5016.6622.89
沧州市16.2417.7121.3520.7818.5014.1818.2612.2120.3127.52
廊坊市22.5921.5732.4428.7421.5114.2215.9711.1116.5717.02
衡水市17.5619.1115.2516.2422.2118.6116.3112.7717.2218.60
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河北省2015—2024年≥60岁人群梅毒按地区报告发病率（1/10万）

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地区2015年2016年2017年2018年2019年2020年2021年2022年2023年2024年
石家庄市27.7424.9823.1924.7425.5016.9520.6815.6817.9317.72
唐山市24.1319.2917.2018.5919.2918.7122.6112.3420.7518.60
秦皇岛市17.9221.3326.0728.3836.8036.5222.7920.1631.6331.70
邯郸市11.6312.9513.8419.6517.9519.8617.8313.3011.9715.26
邢台市16.8512.2816.5120.7521.4327.9726.1921.2923.7732.06
保定市15.0617.5922.8220.6814.1812.3912.378.3111.7218.66
张家口市34.5127.6731.5549.7143.5835.8535.3721.3733.4237.59
承德市47.5134.3340.3641.2928.4721.3216.6715.5016.6622.89
沧州市16.2417.7121.3520.7818.5014.1818.2612.2120.3127.52
廊坊市22.5921.5732.4428.7421.5114.2215.9711.1116.5717.02
衡水市17.5619.1115.2516.2422.2118.6116.3112.7717.2218.60
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2015—2024年河北省≥60岁人群梅毒流行特征分析
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张亚丽 1 , 王敬丘 1 , 张岩 2 , 路新利 1 , 王伟 1 , 成效莹 1
现代预防医学 | 疾病预防控制 2026,53(9): 1704-1709
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现代预防医学 |疾病预防控制 2026 , 53 (9) : 1704 -1709
2015—2024年河北省≥60岁人群梅毒流行特征分析
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张亚丽（1978—），女，硕士，副主任技师，研究方向: 性病艾滋病宣传教育与干预

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张亚丽1, 王敬丘1 , 张岩2, 路新利1, 王伟1, 成效莹1
作者信息
  • 1.河北省疾病预防控制中心性病艾滋病防治所，河北 石家庄 050021
  • 2.石家庄市桥西区汇通华城社区卫生服务站
通讯作者:
王敬丘，E-mail：
作者简介:

张亚丽（1978—），女，硕士，副主任技师，研究方向: 性病艾滋病宣传教育与干预

Epidemiological characteristics of syphilis among people aged 60 years and above in Hebei Province from 2015 to 2024
Ya-li ZHANG1, Jing-qiu WANG1 , Yan ZHANG2, Xin-li LU1, Wei WANG1, Xiao-ying CHENG1
Affiliations
  • Institute for AIDS/STD Control and Prevention, Hebei Province Center for Disease Control and Prevention, Shijiazhuang, Hebei 050021, China
出版时间: 2026-05-10 doi: 10.20043/j.cnki.MPM.202510106
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摘要
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目的

了解2015—2024年河北省≥60岁人群梅毒流行特点，为制订防控策略提供依据。

方法

通过中国疾病预防控制信息系统收集2015—2024年河北省梅毒报告数据，应用描述流行病学方法进行分析。

结果

2015—2024年河北省≥60岁人群梅毒报告病例数由2 261例上升至3 570例，梅毒报告发病率由21.32/10万上升至22.19/10万。一期梅毒报告发病率呈下降趋势，二期梅毒报告发病率呈先上升后下降趋势，三期梅毒报告发病率未见线性趋势变化，隐性梅毒报告病例数呈上升趋势。一期梅毒和二期梅毒所占比例由26.54%下降至6.00%，隐性梅毒病例所占比例由72.76%增加至93.56%。十年间，每年男性报告病例数和发病率均高于女性。年均发病率最高的是85岁及以上年龄组（34.19/10万）。

结论

2015—2024年河北省≥60岁人群梅毒报告病例数逐年增加，隐性梅毒所占比例高，呈现上升趋势，提示我们应进一步加强关注老年人性健康，结合其疾病特点，落实针对性防控措施。

梅毒  /  老年人  /  流行状况
Objective

To understand the epidemiological characteristics of syphilis among people aged 60 years and above in Hebei Province from 2015 to 2024, and to provide a basis for formulating prevention and control strategies.

Methods

Data on syphilis cases reported in Hebei Province from 2015 to 2024 were collected through the Chinese Disease Prevention and Control Information System, and descriptive epidemiological methods were used for analysis.

Results

The number of syphilis cases reported among people aged 60 and above in Hebei Province increased from 2 261 to 3 570, and the reported incidence rate rose from 21.32 per 100 000 to 22.19 per 100 000. The reported incidence rate of primary syphilis showed a downward trend, while that of secondary syphilis showed an initial increase followed by a decrease. The reported incidence rate of tertiary syphilis did not show a linear trend change. The number of reported cases of latent syphilis showed an upward trend. The proportion of primary and secondary syphilis decreased from 26.54% to 6.00%, while the proportion of latent syphilis cases increased from 72.76% to 93.56%. During the ten years, the number of reported cases and the incidence rate among men were higher than those among women each year. The highest average annual incidence rate was observed in the age group of 85 years and older (34.19 per 100 000 population).

Conclusion

The number of syphilis cases reported among people aged 60 and above in Hebei Province has been increasing year by year from 2015 to 2024, with a high proportion of latent syphilis showing an upward trend. This suggests that we should further pay attention to the sexual health of the elderly, and implement targeted prevention and control measures based on their disease characteristics.

Syphilis  /  Elderly people  /  Epidemiological characteristics
张亚丽, 王敬丘, 张岩, 路新利, 王伟, 成效莹. 2015—2024年河北省≥60岁人群梅毒流行特征分析. 现代预防医学, 2026 , 53 (9) : 1704 -1709 . DOI: 10.20043/j.cnki.MPM.202510106
Ya-li ZHANG, Jing-qiu WANG, Yan ZHANG, Xin-li LU, Wei WANG, Xiao-ying CHENG. Epidemiological characteristics of syphilis among people aged 60 years and above in Hebei Province from 2015 to 2024[J]. Modern Preventive Medicine, 2026 , 53 (9) : 1704 -1709 . DOI: 10.20043/j.cnki.MPM.202510106
正文
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伴随人口结构老龄化进程加速，性传播疾病中老年群体所占比例呈持续上升趋势，梅毒、艾滋病等重点防治的性传播疾病，其报告病例数的增长态势尤为显著，已成为不容忽视的公共卫生问题[1-2]。中国老年人口基数持续扩大[3]，即便该群体中仅有一小部分人存在高危性行为，其绝对数量仍构成一个规模可观的风险人群，增加梅毒感染风险。老年人普遍缺乏系统性防病教育，安全套使用意识尤其薄弱[4]。他们对梅毒等性传播疾病的认知水平较低，风险感知不足，普遍未将自己视为易感人群[5]。离退休后，老年人拥有更多的闲暇时间和情感需求，其中一部分人通过商业性服务或非婚性行为满足心理与生理需要[6]。独居老人之间形成非固定伴侣关系的情况较为常见，此类关系可能并不稳定，存在多性伴现象，进一步增加了感染和传播风险。为掌握河北省老年群体梅毒流行特征和趋势，本文对2015-2024年≥60岁人群的梅毒疫情数据进行分析，旨在为制定防控策略提供依据。
1　资料与方法
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1.1　资料来源
病例资料来源于中国疾病预防控制信息系统传染病监测信息系统，按“发病日期”“已审核”“现住址”导出2015-2024年梅毒病例报告卡，筛选出年龄≥60岁的病例。人口学资料来源于国家统计局公布的基本信息系统数据，为常住人口。病例诊断2018年8月1日前按照《梅毒诊断标准》（WS 273-2007）[7]执行，2018年8月1日开始按照《梅毒诊断标准》（WS 273-2018）[8]执行。
1.2　方法
以梅毒报告病例数为分子、人口数为分母，分别按年、梅毒类型、性别、年龄和地区计算报告发病率。
1.3　统计分析
应用 Excel 2010软件建立数据库，使用R 4.4.1软件进行统计分析。率的比较用χ2检验，趋势性检验使用线性趋势χ2检验，检验水准α=0.05。
2　结果
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2.1　流行趋势
2015—2024年，河北省共报告≥60岁梅毒病例27 965例，梅毒报告发病率由2015年的21.32/10万上升至2024年的22.19/10万，疫情总体呈上升趋势（χ2趋势=48.454，P<0.001）。其中2018年梅毒报告发病率最高，为24.41/10万，2022年最低，为14.36/10万。见图1。2015-2024年，一期梅毒（χ2趋势=724.170，P<0.001）、二期梅毒（χ2趋势= 285.420，P<0.001）报告发病率呈下降趋势，一、二期梅毒在全部梅毒病例报告数中的构成比由26.54%降升至6%；三期梅毒报告发病率未见线性趋势变化；隐性梅毒报告病例数呈上升趋势，在全部梅毒病例报告数中的构成比由72.76%升至93.56%。见表1。
2.2　人群分布
2.2.1　性别分布
2015—2024年，各年度男性梅毒报告病例数和发病率均高于女性，报告发病率男女性别比最高为2022年的1.56∶1，最低为2024年的1.43∶1。2015-2024年，男性报告发病率由25.34/10万上升至26.42/10万，总体呈上升趋势（χ2趋势=24.043，P<0.001），年均增长率为0.42%；女性梅毒报告发病率由17.47/10万上升至18.47/10万，总体呈上升趋势（χ2趋势=18.205，P<0.001），年均增长率为0.56%。见表2、图1。
2.2.2　年龄分布
2015—2024年，年均发病率最高的是85岁及以上年龄组，为34.19/10万，年均发病率最低的是60～64岁组，为14.01/10万。65～69岁组梅毒报告发病率由24.52/10万下降至15.74/10万，总体呈下降趋势（χ2趋势=94.177，P<0.001）；70～74岁组梅毒报告发病率由22.95/10万上升至25.50/10万，总体呈上升趋势（χ2趋势=49.439，P<0.001）；75～79岁组梅毒报告发病率由24.76/10万上升至35.79/10万，总体呈上升趋势（χ2趋势=37.952，P<0.001）；85岁及以上年龄组梅毒报告发病率由49.75/10万下降至28.06/10万，总体呈下降趋势（χ2趋势=44.089，P<0.001）；60～64岁组和80～84岁组梅毒报告发病率未见线性趋势变化。70～74岁、75～79岁、80～84岁组梅毒报告发病率年均增幅分别为1.06%、3.76%、3.49%；65～69岁、85岁及以上年龄组发病率年均降幅分别为4.35%、5.42%；60～64岁组报告发病率变化不明显。见表3。
2.3　地区分布
全省11个地市中，年均发病率居前五位的是张家口市（35.06/10万）、承德市（28.50/10万）、秦皇岛（27.33/10万）、邢台市（21.91/10万）、石家庄（21.51/10万）。承德市、石家庄市、廊坊市、唐山市梅毒报告发病率呈下降趋势，年均降幅分别为7.80%、4.86%、3.10%、2.85%，其余7个地市均有不同程度上升，上升幅度居前五位的为邢台市、秦皇岛市、沧州市、邯郸市、保定市，年均增幅分别为7.42%、6.55%、6.03%、3.07%、2.41%。见表4。
3　讨论
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河北省 2015—2024年≥60岁人群梅毒报告发病率高于同期本省全人群水平，与国内相关研究结果一致，但低于云南玉溪、贵州、浙江、北京等省市的发病水平[9-12]。这一方面反映了老年人群因慢性病多发、住院手术频繁而接受更多医疗筛查，导致病例发现率提高；另一方面也提示，随着社会变迁，老年群体的性观念和行为模式可能正在发生改变，潜在感染风险不容忽视。2020—2022年河北省老年人群梅毒报告病例数和发病率均下降，除与新型冠状病毒肺炎疫情防控措施导致的社交减少直接相关外，也可能与疫情期间部分非紧急医疗服务受限、常规筛查减少有关[13]。而2023—2024年发病率的回升，则提示随着社会生活恢复正常，老年人群的梅毒传播风险可能再次显现，防控工作需持续关注。
本研究中一期梅毒报告发病率呈下降趋势，二期梅毒报告发病率呈先上升后下降趋势，这一变化考虑一期、二期梅毒发病率的下降，特别是从2019年之后的显著下降，表明河北省近年来推行的梅毒综合防控措施，包括扩大筛查、促进早诊早治、规范性病服务等，在阻断疾病传播、防止感染向显性阶段发展方面取得了初步成效。然而，二期梅毒在2018年前后的上升，可能反映了此前一段时期内感染未被及时发现而进展至二期，这也从侧面印证了加强早期筛查和干预的必要性[14]。三期梅毒报告发病率始终处于极低水平，表明近年来有效的治疗阻断了疾病向严重临床结局（如神经梅毒、心血管梅毒）的发展，避免了更大的疾病负担。
隐性梅毒报告病例占比逐年升高，可能原因：一是老年人因常患高血压、糖尿病、心脑血管疾病和骨科疾病等原因，住院和接受手术的频率高于年轻人，使大量无症状的隐性梅毒感染者在临床诊疗过程中被筛查发现[15-17]；二是老年人免疫功能随年龄增长逐渐下降，可能导致机体对梅毒螺旋体的免疫应答发生改变，存在检测结果出现假阳性上报为隐性梅毒的可能[18-20]。还需考虑以下两点：其一，老年隐性梅毒中可能存在相当比例的“血清固定”现象，即患者经规范治疗后非梅毒螺旋体抗原血清学试验（如RPR）滴度维持阳性而难以转阴，这部分人群在后续住院筛查中会被重复报告为隐性梅毒，推高了统计数字。其二，也可能反映了老年群体中梅毒感染的“冰山现象”——大量无症状感染者通过日益普及的医疗筛查得以“浮出水面”。这一趋势提示，未来的防控重点需从单纯治疗显性病例，向主动发现和管理庞大的隐性感染人群转变，以彻底清除传染源。
在导致性别分布差异的因素中，寻求商业性服务的顾客主要为男性，这是男性报告发病率较高的主要原因[21]。老年男性，特别是丧偶或独居者，可能通过商业性服务满足生理与心理需求，且安全套使用率低，感染风险高。其次，部分老年男性存在男性同性性行为，而该人群中的梅毒感染率通常较高，且隐蔽性更强。此外，社会性别角色差异也不容忽视，男性往往被视为性行为的主导方，其就医的羞耻感可能低于女性；而老年女性受传统观念束缚更深，更倾向于选择隐瞒病情或寻求非正规治疗，导致女性病例的漏报或延迟报告，从而在统计数据上进一步拉大了性别差距。
年均发病率最高的是85岁及以上年龄组。对这一现象进行分析。一方面，高龄老人频繁的医疗接触极大地提高了隐性感染的检出概率，从而提高了报告发病率。另一方面，也不能完全忽视该年龄段极少数人群仍存在性活动的可能性。提示当前策略对行为干预与源头预防关注不够，今后要构建一个融合精准筛查、诊疗联动与健康促进的综合防控框架，以推动防控策略从“被动发现”向“主动干预”转型。
河北省北部地区（张家口市、承德市和秦皇岛市）年均发病率相对较高。这种区域聚集性可能由多重因素共同导致。首先，地理与经济因素。北部地区毗邻京津等大城市，人口双向流动频繁，可能输入或扩散疫情；同时，这些地区作为旅游城市，流动人口构成复杂，增加了高危行为的发生机会。其次，医疗资源与筛查力度。经济发展水平相对较高的地区，往往具备更完善的医疗服务体系和更主动的筛查项目，病例发现能力更强，可能导致报告发病率“虚高”。最后，可能还存在地区性的文化或行为差异。因此，在制定区域化策略时，需结合各地的人口流动模式、医疗资源配置和已观察到的疫情趋势进行综合分析，避免将“报告率高”简单地等同于“风险高”。
当前研究表明，老年群体中梅毒的发病率持续攀升[22]。伴随社会人口结构的快速老龄化，该人群感染性传播疾病的风险进一步提高[23-24]。基于本研究结果及讨论，我们构建一个多层次、综合性的老年梅毒防控策略体系：（1）完善政策与服务体系，实现医防融合与资源整合：充分整合利用艾滋病防治资源与平台，推动建立“卫生健康部门主导、多部门协作、社区参与”的老年性病防控联动机制。依托社区老年健康管理项目、养老机构健康服务、基层医疗卫生服务等现有平台，将梅毒筛查与健康教育作为老年健康管理的常规内容。制定区域化精准防控策略时，明确指向老年群体的特殊需求，例如，在高发地区试点将梅毒快速检测纳入65岁以上老年人年度健康体检的自选项目。（2）强化医疗系统主动发现与规范管理能力：加强医疗机构，尤其是皮肤性病科、泌尿外科、妇科、肛肠科及老年科等重点科室的梅毒筛查意识与能力。制定并推广《老年人梅毒筛查与诊疗临床路径》，明确筛查指征和转诊流程。重点强化对有性活跃行为迹象（如因STD相关症状就诊、主动咨询等）的老年男性群体的干预，而非单纯对高龄人群进行普遍筛查。将性病咨询服务与艾滋病自愿咨询检测（VCT）、慢性病管理中心等服务相结合，提供一站式、保密的检测与咨询服务。加强性病规范化服务的培训与督导，确保诊断准确、治疗规范、疫情报告及时完整。（3）开展贴近需求的社区健康教育与行为干预：对老年人群开展系统性的性健康教育。宣传内容应科学、具体、通俗，涵盖梅毒的危害、传播途径（强调安全套的有效性）、无症状感染的可能性及检测的重要性。针对可能的感染途径（非婚性行为、商业性服务）和场所（公园、棋牌室、非正规娱乐场所等），设计有针对性的干预信息。通过社区卫生服务中心的健康讲座、家庭医生签约服务面对面宣教、社区宣传栏图文资料、老年大学健康课程、地方电视台/广播电台老年栏目、以及子女关怀传递等多种渠道进行渗透。核心目标是提升老年人的风险意识、自我防护技能和主动检测意愿，营造“积极老龄化”和“健康性生活”的社区氛围。（4）建立动态监测与效果评估机制：在常规疫情监测基础上，应加强对老年梅毒病例报告的质控分析，定期核查报告的及时性、完整性与准确性，减少重复报告。探索建立老年梅毒专题监测模块，收集更详细的行为学、就医史等信息，以区分新近感染与既往感染，更准确地评估真实风险与防控效果。定期对防控策略的实施效果进行评估，根据流行病学趋势变化和循证证据，动态调整干预重点和资源投入方向。总之，应对老年梅毒的流行，需要构建融合疾病预防、健康促进、规范诊疗和人文关怀的综合防控体系，才能有效遏制梅毒在老年人群中的传播，提升该群体的整体健康水平和生活质量。

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2026年第53卷第9期
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doi: 10.20043/j.cnki.MPM.202510106
  • 接收时间：2025-10-10
  • 首发时间：2026-11-02
  • 出版时间：2026-05-10
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    1.河北省疾病预防控制中心性病艾滋病防治所，河北 石家庄 050021
    2.石家庄市桥西区汇通华城社区卫生服务站

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Number of
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Number of
species		 占总种数比例
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total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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