Abstract: Background　Syphilis is a global public health problem.Primary syphilis is closely associated with HIV infection and can promote the infection.Moreover, it increases the risk of transmission of acquired immunodeficiency syndrome by 3 to 5 times. The number of recently reported cases of syphilis in China is increasing rapidly. It ranks third among Class A and B infectious diseases in terms of incidence, and has become an important public health and social problem. Objective　To investigate the epidemiological characteristics of syphilis, a common sexually transmitted disease, in Songjiang District of Shanghai from 2007 to 2017, to provide scientific evidence for the development of targeted prevention and control measures.Methods　Data of reported and monitored syphilis cases in Shanghai's Songjiang District from 2007 to 2017 were collected and descriptively analyzed. Results　A total of 8 546 cases of syphilis were reported in Songjiang District of Shanghai from 2007 to 2017, with an average annual incidence rate of 48.23/100 000. The average annual incidence rates of primary, secondary, and latent syphilis were 14.14/100 000, 9.66/100 000 and 24.33/100 000, respectively. During this period, the overall incidence of syphilis showed a U-shaped upward trend.It peaked（68.17/100 000） in 2016. The incidence of syphilis decreased by 6.13/100 000 per year from 2007 to 2010, but increased by 5.64/100 000 annually from 2010 to 2017.The characteristics of this group of syphilis were: latent syphilis accounted for 51.84%（4 430/8 546）; the reported cases peaked from June to September; local residents made up a large majority of the total〔57.65%（4 927/8 546）〕; male-female ratio was 1∶1.06; persons aged 20 to 59 accounted for 81.24%（6 943/8 546） of the total．Subgroup analysis by place of hukou and gender showed that, local males outnumbered females, with a male-female ratio of 1.30∶1 in general, and a male-female ratio of 1.73∶1 among the primary or secondary syphilis cases.However, among nonlocal cases, males were less than females, showing a male-female ratio of 0.60∶1 in general.Subgroup analysis by gender and age group found that females of 20-49 years accounted for 74.75%（3 289/4 400） of all the female cases, and males of 20-49 years accounted for 56.82%（2 356/4 146） of all the male cases, indicating that younger females were associated with increased risk of syphilis. Subgroup analysis by stage of syphilis and gender revealed that, the prevalence of primary syphilis was higher in males than that of females〔35.50%（1 472/4 146）vs 20.98%（923/4 400）〕. But the prevalence of secondary syphilis was lower in males than that of females〔19.83%（822/4 146）vs 20.02%（881/4 400）〕, and the prevalence of latent syphilis was also lower in males than that of females〔44.40%（1 841/4 146）vs 58.84%（2 589/4 400）〕.Most local syphilis cases were 30-59 years old〔59.06%（2 910/4 927）〕, but most nonlocal syphilis cases were 20-49 years old〔85.24%（3 085/3 619）〕. Conclusion　The incidence of syphilis in Songjiang District is increasing year by year. To control the transmission and dissemination of syphilis, the following measures are recommended: strengthening the monitoring of syphilis and standardizing the treatment according to specific syphilis features, enhancing syphilis screening in females（including local and nonlocal）and local older people, intensifying the propaganda of sexually transmitted diseases prevention and treatment, and advocating safer sex behaviors.

Key words: Syphilis, Recessive syphilis, Epidemiology, Epidemic situation, Incidence

摘要： 背景　梅毒是一个全球性的公共卫生问题，一期梅毒易合并和促进人类免疫缺陷病毒（HIV）感染的传播，可使获得性免疫缺陷综合征传播的危险性增加3~5倍。近年来，我国梅毒报道病例数快速增长，居甲乙类传染病发病排序第3位，已成为重要的公共卫生和社会问题之一。目的　了解2007—2017年上海市松江区以梅毒为主的性传播疾病流行特征，为进一步制定预防与控制措施提供科学依据。方法　收集2007—2017年松江区报告和监测的梅毒病例资料，并对其进行描述性分析。结果　2007—2017年上海市松江区共计报告梅毒8 546例，年均发病率为48.23/10万，其中一期、二期、隐性梅毒年均发病率分别为14.14/10万、9.66/10万、24.33/10万。2007—2017年总体发病呈U型上升趋势，2016年为发病最高峰（68.17/10万），2007—2010年梅毒发病率年均下降了6.13/10万，2010—2017年年均增长5.64/10万。本组梅毒病例特点为：隐性梅毒占51.84%（4 430/8 546）、6~9月份为报告病例数高峰时段、以本地户籍〔57.65%（4 927/8 546）〕为主、男女性别比1∶1.06、20~59岁占梅毒病例的81.24%（6 943/8 546）。本市户籍男性多于女性，男女性别比为1.30∶1（特别是一期、二期梅毒性别比达1.73∶1）；外省市户籍病例男性少于女性，男女性别比为0.60∶1；女性感染较男性更为年轻化，20~49岁分别占74.75%（3 289/4 400）、56.82%（2 356/4 146）。男性一期梅毒〔35.50%（1 472/4 146）〕高于女性〔20.98%（923/4 400）〕，而女性二期梅毒〔20.02%（881/4 400）〕及隐性梅毒〔58.84%（2 589/4 400）〕高于男性〔19.83%（822/4 146）、44.40%（1 841/4 146）〕；一、二期梅毒本地病例以30~59岁〔59.06%（2 910/4 927）〕为主，外省市则以20~49岁〔85.24%（3 085/3 619）〕为主。结论　2007—2017年松江区梅毒发病率呈逐年上升趋势，应根据其特点，加强监测，规范梅毒的诊疗，加大性传播疾病防治宣传力度、提倡安全性行为，加强对女性及本市老年人口的筛查，控制梅毒的蔓延和传播。

关键词: 梅毒, 隐性梅毒, 流行病学, 疫情, 发病率