中国麻风皮肤病杂志 ›› 2019, Vol. 35 ›› Issue (11): 667-669.doi: 10.12144/zgmfskin201911667

• 短篇论著 • 上一篇    下一篇

头孢曲松治疗HIV阴性无症状神经梅毒后实验室指标的变化

翁文佳  闫俊玲  高艳青   

  1. 首都医科大学附属北京佑安医院皮肤科，北京，100069
  • 出版日期:2019-11-15 发布日期:2019-11-20
  • 通讯作者: 高艳青，E-mail：gyqing2001bj@sina.com

Laboratory characteristics of HIV-negative patients with asymptomatic neurosyphilis after ceftriaxone treatment

WENG Wenjia，YAN Junling，GAO Yanqing   

  1. Department of Dermatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
  • Online:2019-11-15 Published:2019-11-20
  • Contact: GAO Yanqing，E-mail：gyqing2001bj@sina.com

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摘要： 目的：检测无症状神经梅毒患者治疗前后血液、脑脊液（CSF）相关指标的变化，探讨其对预后的意义。方法：回顾性分析2016年3月至2018年12月于我科确诊并治疗的34例无症状神经梅毒患者的一般资料及相关实验室检查：包括血液快速血浆反应素环状卡片试验（RPR）、脑脊液白细胞（CSF-WBC）、蛋白量（CSF-PRO）、CSF-RPR、脑脊液梅毒螺旋体明胶颗粒凝集试验（CSF-TPPA）。结果：经过1个疗程头孢曲松钠驱梅治疗，治疗前及治疗后脑脊液白细胞中位数（四分位数）分别为0.0105（0.0068，0.022）和0.005（0.0028，0.0105），差异有统计学意义(Z=-2.738，P=0.005)；脑脊液蛋白中位数（四分位数）分别为0.3（0.155, 0.485）和0.16（0.13, 0.245），差异有统计学意义（Z=-2.092，P=0.036）；与治疗前相比，治疗后3个月、6个月、12个月时血RPR下降≥4倍者分别为6例（17.65%）、9例（26.47%）和16例（47.06%）。结论：头孢曲松钠治疗后，脑脊液白细胞下降及蛋白下降，对于无法行腰椎穿刺的患者，可通过血RPR下降≥4倍来初步评价疗效。

关键词: 无症状神经梅毒, 实验室特征

Abstract: Objective: To detect the changes of indexes in blood and cerebrospinal fluid (CSF) before and after ceftriaxone treatment in HIV-negative patients with asymptomatic neurosyphilis and investigate the significance of prognosis. Methods: The clinical and laboratory test data of 34 patients with asymptomatic neurosyphilis in our department from March 2016 to December 2018 was analyzed, including serum- rapid plasma reagin test (RPR), CSF-leukocytes、CSF-protein amount, CSF-RPR, treponemalpallidumparticleagglutination (TPPA). Results: After 1 course of treatment with ceftriaxone sodium, the median (quartile) of CSF leukocytes and cerebrospinal fluid protein were 0.005 (0.0028, 0.0105) and 0.16 (0.13, 0.245), which were lower than those before treatment 0.0105 (0.0068, 0.022), and 0.3 (0.155, 0.485), with significant differences (Ps<0.005). Compared with before treatment, the blood RPR decreased by ≥4 times at 3 months, 6 months, and 12 months after treatment in 6 (17.65%), 9 (26.47%), and 16 cases (47.06%), respectively. Conclusion: After treatment with ceftriaxone sodium, If the level of leukocyte and protein of CSF decreases and the blood RPR decreases by≥4 times, we can preliminarily predict that the patient is  cured.

Key words: asymptomatic neurosyphilis, laboratory characteristics