中国麻风皮肤病杂志 ›› 2024, Vol. 40 ›› Issue (11): 769-773.doi: 10.12144/zgmfskin202411769

• 论著 • 上一篇    下一篇

HIV感染合并有症状和无症状神经梅毒临床及实验室指标分析

杜健群,李水凤,李英,卢斯汉,莫子茵   

  1. 广州医科大学附属市八医院，广州市传染病临床医学研究所皮肤性病科，广东广州，510000
  • 出版日期:2024-11-15 发布日期:2024-10-14

Comparation of clinical features and laboratory data between symptomatic and asymptomatic neurosyphilis in HIV patients

DU Jianqun, LI Shuifeng, LI Ying, LU Sihan, MO Ziyin   

  1. Guangzhou Medical Research Institute of Infectious Diseases, Dermatology Department，Guangzhou Eighth People's Hospital, Guangzhou Medical University， Guangzhou 510000, China
  • Online:2024-11-15 Published:2024-10-14

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摘要： 目的：比较HIV感染者有症状和无症状神经梅毒的临床及实验室指标。方法：回顾性分析我院2016年1月至2022年6月住院治疗的人类免疫缺陷病毒感染（HIV）合并神经梅毒患者临床资料，根据临床症状与体征分为有症状神经梅毒（有症状组）与无症状神经梅毒（无症状组），对其临床特点、影像学资料以及血清学、脑脊液实验室特征进行比较。结果：共分析110例患者，其中有症状组67例，男65例，女2例，平均年龄（38.22±11.73）岁；无症状组43例，男42例，女1例，平均（36.86±11.76）岁。有症状组有明确驱梅史及抗逆转录病毒治疗史比例均显著低于无症状组（P<0.05）。有症状组脑脊液WBC计数、脑脊液总蛋白水平均高于无症状组（均P<0.05），有症状组脑脊液TRUST阳性率及滴度水平分别高于无症状组（均P<0.05)。两组血清CD4+T淋巴细胞计数、TRUST阳性率、滴度水平无显著差异（均P>0.05）。结论：HIV合并有症状神经梅毒患者脑脊液炎症指标更高。神经梅毒症状易发生在无驱梅史及抗逆转录病毒治疗史的HIV患者。

关键词: 神经梅毒, 人类免疫缺陷病毒, 有症状, 无症状

Abstract: Objective: To compare the clinical features and laboratory index between symptomatic and asymptomatic neurosyphilis in HIV-infected patients. Methods: The data of human immunodeficiency virus (HIV) infection who were hospitalized in our hospital from January 2016 to June 2022 were analyzed. They were divided into symptomatic neurosyphilis (SNS) and asymptomatic neurosyphilis (ANS) group according to clinical symptoms and signs. The clinical characteristics, imaging data, serology, and cerebrospinal fluid laboratory characteristics were retrospectively analyzed. Results: A tall of 110 neurosyphilis cases were analyzed, including 67 in SNS group (65 males and 2 females), with an average age of (38.22±11.73) years, and 43 in ANS group (42 males and 1 female), with an average age of (36.86±11.76) years. The proportions of patients with a history of antisyphilitcic treatment and antiviral therapy in SNS group were significantly lower than that in ANS group (P<0.05). The WBC count, protein quantification, TRUST positive rate and titer level of CSF in SNS group were higher than that in ANS group separately (Ps<0.05). There were no significant differences in serum CD4+T lymphocyte count, TRUST abnormality rate, TRUST titer level between the two groups (Ps>0.05). Conclusion: The level of cerebrospinal fluid inflammatory indicators in the patients with symptomatic neurosyphilis is higher. SNS are more likely to occur in patients with HIV who have no history of antisyphilitcic or antiretroviral therapy.

Key words: neurosyphilis, human immunodeficiency virus, symptomatic, asymptomatic