神经梅毒的临床特征分析  

Clinical Characteristics of Neurosyphilis

作　　者：徐志鹏[1] 黎红华[1] 陈文军[1] 武强[1] 林琅[1] 

机构地区：[1]广州军区武汉总医院神经内科,武汉430070

出　　处：《神经损伤与功能重建》2014年第1期44-46,共3页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨神经梅毒的临床特征及早期诊断依据。方法:回顾性分析2010年5月至2013年1月收治的10例神经梅毒患者的临床资料。结果:本组神经梅毒患者首发症状为痴呆3例、脊髓痨3例、脑梗死1例、脑膜炎1例、帕金森综合征1例和癫痫1例。10例患者的血浆梅毒螺旋体血凝试验(TPPA)及快速血浆反应素试验(RPR)均呈阳性。腰穿脑脊液压力均正常,脑脊液蛋白增高9例,白细胞增高(以淋巴细胞为主)4例。脑脊液TPPA阳性8例,RPR阳性5例。头颅MRI显示不同程度的脑萎缩,部分患者脑内或脊髓多发散在长T1长T2信号。驱梅治疗后大部分患者症状明显改善。结论:结合临床表现、实验室及影像学检查有助于神经梅毒的早期诊断,早期治疗可明显改善预后。Objective：To investigate the clinical characteristics and early diagnostic evidence of neurosyphilis. Methods： Clinical data of 10 cases with neurosyphilis who were hospitalized from May 2010 to January 2013 were retrospectively analyzed. Results： The initial symptoms of 10 neurosyphilis patients included dementia （3 cases）, tabes dosalis （3 cases）, cerebral infarction （1 case）, meningitis （1 case）, Parkinson syndrome （1 case） and epilepsia （1 case）. The treponema pallidum particle assay （TPPA） and rapid plasma regain test （RPR） of 10 serum samples were positive. Cerebrospinal fluid （CSF） examination revealed a normal pressure in all the cases.. CSF protein was increased in 9 cases and leukocyte counts （predominantly lymphocytes） were increased in 4 cases. TPPA was positive in 8 CSF samples and RPR in 5. MRI revealed brain atrophy and multiple lesions manifesting T2 high signal intensity and T1 low signal intensity in the brain or spine cord. Most of the patients＇ symptoms were improved significantly afler treatment of syphilis. Conclusion： The diagnosis of neurosyphilis depends on clinical presentation, laboratory and imaging examinations. Early treatment of neurosyphilis can improve the prognosis.

关 键 词：神经梅毒 临床特点 影像学 

分 类 号：R741[医药卫生—神经病学与精神病学] R759.1[医药卫生—临床医学]