中国麻风皮肤病杂志 ›› 2023, Vol. 39 ›› Issue (8): 568-570.doi: 10.12144/zgmfskin202308568

• 论著 • 上一篇    下一篇

驱梅治疗后血清RPR未转阴患者神经梅毒情况分析

张明,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:2023-08-15 发布日期:2023-07-19

Analysis of neurosyphilis in patients who still positive for RPR after syphilis treatment

ZHANG Ming, WENG Wenjia, YAN Junling, GAO Yanqing   

  1. Department of Dermatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
  • Online:2023-08-15 Published:2023-07-19

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摘要： 目的：初步探索经过驱梅治疗后，血清RPR未转阴的梅毒患者神经梅毒的发生情况。方法：回顾性分析2020年1月至2021年12月在我科进行腰穿的梅毒患者。患者符合驱梅治疗后血清RPR下降≥4倍但未转阴，RPR滴度波动于1个稀释度时间≥12个月，且无视觉、听觉及神经系统症状。结果：共纳入36例患者，其中4例符合神经梅毒，9例符合疑似神经梅毒，无症状神经梅毒的发生率为36.1%。结论：对于驱梅治疗后RPR下降≥4倍，持续12个月仍未转阴的患者，建议进行腰椎穿刺排除神经梅毒可能。

关键词: 梅毒, 腰椎穿刺, 神经梅毒

Abstract: Objective: To investigate the occurrence of neurosyphilis in patients whose RPR without sero-conversion after syphilis treatment. Methods: The data of syphilis patients who underwent lumbar puncture in our department from January 2020 to December 2021 were retrospectively analyzed. Patients in this study met the criteria that serum RPR titer declined ≥4-fold but did not convert to negative after syphilis treatment, RPR titer fluctuated at 1 dilution persist ≥12 months without visual, auditory, or neurological symptoms. Results: A total of 36 patients were enrolled, including 4 confirmed case of neurosyphilis and 9 suspected case. The incidence of asymptomatic neurosyphilis was 36.1%. Conclusion: Lumbar puncture is recommended to exclude the possibility of neurosyphilis in patients whose RPR decreased ≥4-fold but did not convert to negative for at least 12 months after syphilis treatment.

Key words: syphilis, lumbar puncture, neurosyphilis