129例未经治疗的早期梅毒患者脑脊液检测结果的分析  

Analysis on the Study on Cerebrospinal Fluids from 129 Cases of Untreated Early Syphilis

作　　者：李民[1] 徐敬星[1] 史同新[1] 于增照[1] 张骋[1] 刘树萍[1] 

机构地区：[1]青岛市市立医院皮肤科,山东青岛261023

出　　处：《皮肤性病诊疗学杂志》2014年第3期185-188,共4页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：山东省自然科学基金(编号:ZR2010HM113)

摘　　要：目的:探讨未经治疗的早期梅毒脑脊液各项检测的意义及其对神经梅毒的诊断价值。方法:对129例未经治疗的早期梅毒患者脑脊液进行细胞计数和蛋白定量、VDRL、FTA-ABS、RPR、TPPA检测以及RT-PCR检测TP,并分析不同RPR滴度组及不同RT-PCR结果组脑脊液异常率的差异。结果:脑脊液细胞或蛋白异常者30例(23.26%),VDRL阳性2例(1.55%),FTA-ABS阳性3例(2.33%),RPR阳性5例(3.88%),TPPA阳性10例(7.75%),RT-PCR阳性32例(24.81%)。2例(1.55%)确诊为神经梅毒。血清RPR滴度≤1∶16组与≥1∶32组患者CSF异常率差异有统计学意义(2=8.37,P=0.004)。脑脊液RT-PCR检测阳性与阴性组脑脊液异常率差异有统计学意义(2=4.49,P=0.034)。结论:血清RPR滴度≥1∶32者脑脊液异常率较高,临床中应引起重视。单纯对于未经治疗的早期梅毒而言,用PCR检测脑脊液中TP含量的方法对神经梅毒的诊断不具有明显价值。To investigate the significance of the cerebrospinal fluid detection for un-treated early syphilis and the diagnostic value for neurosyphilis.Methods：129 cases of cerebrospi-nal fluid （ CSF） in patients with untreated early syphilis were studied.Cell count, protein quanti-tative determination, VDRL, FTA -ABS, RPR, TPPA, and RT -PCR detection for TP were conducted.The abnormal conditions of cerebrospinal fluid in groups of different RPR titer and RT-PCR results were analyzed.Results：Abnormal cells or proteins were detected in cerebrospinal fluid of 30 cases （23.26%） , VDRL positive in 2 cases （1.55%） , FTA-ABS positive in 3 ca-ses （2.33%） , RPR positive in 5 cases （3.88%） , TPPA positive in 10 cases （7.75%） , RT-PCR for TP positive in 32 cases （24.81%） , among them, 2 cases （1.55%） were neurosyphilis. There was a statistical significance in frequency of CSF abnormality between patients with serum RPR titer≤1：16 and≥1：32 （χ2=8.37,P=0.004）, as well as between the RT-PCR posi-tive for TP group and RT-PCR negative group （χ2=4.49,P=0.034） .Conclusion：Clinical at-tention should give to those patients with serum RPR titer≥1：32 and a higher frequency of CSF abnormality.TP detected by PCR in CSF is not particular helpful in for neurosyphilis diagnosis in patients with untreated early syphilis.

关 键 词：早期梅毒 脑脊液 诊断 

分 类 号：R759.11[医药卫生—皮肤病学与性病学]