中国麻风皮肤病杂志 ›› 2021, Vol. 37 ›› Issue (2): 69-71.doi: 10.12144/zgmfskin202102069

• 论著 • 上一篇    下一篇

71例症状性神经梅毒临床分析

李娟1,翁文佳1,闫俊玲1,王俊华2,高艳青1   

  1. 1首都医科大学附属北京佑安医院，北京，100069；2清华大学玉泉医院神经外科中心，北京，100040
  • 出版日期:2021-02-15 发布日期:2021-02-02
  • 通讯作者: 高艳青, E-mail: gaoyanqing@ccmu.edu.cn

Clinical analysis of 71 cases with symptomatic neurosyphilis

LI Juan1, WENG Wenjia1, YAN Junling1, WANG Junhua2, GAO Yanqing1   

  1. 1 Beijing Youan Hospital, Capital Medical University, Beijing 100069, China；
    2 Department of Neurosurgery Center, Tsinghua University Yuquan Hospital, Beijing 100040, China
  • Online:2021-02-15 Published:2021-02-02
  • Contact: GAO Yanqing, E-mail：gaoyanqing@ccmu.edu.cn

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摘要： 目的：分析症状性神经梅毒的临床表现及实验室检查结果。方法：回顾分析2014年3月至2019年1月本院诊治的症状性神经梅毒患者的临床资料。数据资料统计学分析采用SPSS 17.0软件。结果：共分析71例症状性神经梅毒患者，男52例，女19例，年龄23~71岁。 20例（28.2%）有明确梅毒史，12例血清RPR滴度≤1∶4，23例1∶8～1∶32，36例≥1∶64，44例（62%）脑脊液RPR阳性。该组病例中，脑膜血管型39例（54.9%），脑膜炎型 6例（8.5%），麻痹性痴呆23例（32.4%），脊髓痨3例（4.2%）。不同临床类型神经梅毒患者中脑脊液蛋白含量四组间比较差异有统计学意义（P＜0.05），血清RPR滴度和脑脊液白细胞计数差异均无统计学意义（P>0.05）；麻痹性痴呆组脑脊液蛋白含量和RPR阳性率高于脑膜血管型（Ps＜0.05）。结论：本研究中最常见的神经梅毒类型是脑膜血管型神经梅毒。脑脊液蛋白含量水平的升高，可能预示着症状性神经梅毒实质受损的发生。

关键词: 神经梅毒, RPR, 脑脊液

Abstract: Objective: To investigate the clinical characteristics and results of laboratory test results of symptomatic neurosyphilis. Methods: The data of cases with symptomatic neurosyphilis were collected retrospectively in our hospital from March 2014 to January 2019. All the data were analyzed by SPSS 17.0 software. Results: 71 patients with symptomatic neurosyphilis including 52 males and 19 females were collected with the age ranging from 23 to 71 years. 20 patients (28.2%) had a history of syphilis. The RPR titer was ≤1∶4 in 12 cases, 1∶8-1∶32 in 23 cases, and ≥1∶64 in 36 cases (62%), respectively. 44 cases (62%) were positive for RPR in the cerebrospinal fluid (CSF). There were 39 (54.9%) cases with meningovascular neurosyphilis, 6 (8.5%) cases with  meningitis neurosyphilis, 23 (32.4%) cases with paralytic dementia  and 3 (4.2%) cases with tabes dorsalis  in the group. There were significant differences of the CSF protein content among the four groups (P<0.05). There was no significant difference in the serum RPR titers and  the white leukocyte counts in the CSF among the four groups. The levels of CSF protein and the positivity rates of RPR in the patients of aralytic dementia were higher than those of the patients of meningovascular neurosyphilis  (Ps＜0.05). Conclusion: The most common type of symptomatic neurosyphilis was meningovascular neurosyphilis. The high level of CSF protein may indicate the occurrence of parenchymal neurosyphilis.

Key words: neurosyphilis, RPR, cerebrospinal fluid (CSF)