梅毒合并脑梗死患者有无动脉粥样硬化危险因素的临床特征  

Clinical characteristic of patients with syphilis and cerebral infarction complicated with and without atherosclerosis risk factors

作　　者：秦开宇 马小扬 伍文清 黄宇明 许东梅 Qin Kaiyu;Ma Xiaoyang;Wu Wenqing;Huang Yuming;Xu Dongmei(Department of Neurology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院神经内科,北京100015

出　　处：《中华实验和临床感染病杂志（电子版）》2018年第4期354-359,共6页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：感染病科国家临床重点专科建设项目

摘　　要：目的分析梅毒合并脑梗死患者有与无动脉粥样硬化危险因素的差异。方法应用病例回顾分析方法收集2015年4月3日~2017年7月28日于首都医科大学附属北京地坛医院就诊的HIV阴性的梅毒合并脑梗死患者共24例,将梅毒合并脑梗死患者分为无动脉粥样硬化危险因素组(8例)与有动脉粥样硬化危险因素组(16例),比较两组患者的一般临床资料及脑血管病变分布、神经梅毒所占比例以及既往有脑梗死病史者比例。结果无动脉粥样硬化危险因素组患者平均年龄为(43.0±8.7岁)较有动脉粥样硬化危险因素组患者(58.1±15.2岁)小(t=2.59、P=0.016),两组患者均以男性居多,其中无动脉粥样硬化危险因素组患者中男性62.5%;有动脉粥样硬化危险因素组患者中男性75.0%,差异无统计学意义(χ~2=0.40,P=0.9)。病变血管分布方面,无动脉粥样硬化危险因素组患者较有动脉粥样硬化危险因素组更易累及颅内血管(75.0%vs. 31.3%,χ~2=4.11、P <0.05)。两组患者既往脑梗死病史发生率差异无统计学意义(12.5%vs. 50.0%,χ~2=3.2、P> 0.05)。神经梅毒所占比例差异无统计学意义(62.5%vs. 92.9%、χ~2=3.15、P> 0.05)。结论梅毒合并脑梗死患者无动脉粥样硬化危险因素组平均年龄较小,病变以颅内血管受累为主。Objective To investigate the differences between patients with and without atherosclerosis risk factors of syphilis complicated with cerebral infarction. Methods Total of 24 patients of syphilis complicated with cerebral infarction were collected from April 3 rd, 2015 to July 28 th, 2017 in Beijing Ditan Hospital, Capital Medical University, and were devided into two groups： group with and without atherosclerosis risk factors（8 cases and 16 cases, respectively）. The cerebrospinal fluid and CTA, record general information were detected, and the differences between the two groups were compared, respectively. Results Patients without atherosclerosis risk factors were younger（43.0 ± 8.7 years old） than cases with atherosclerosis risk factors（58.1 ± 15.2 years old）（t = 2.59, P = 0.016）. The preponderance of men exists in both groups, the proportion of male cases was almost equal（62.5% and 75.0% of cases without and with atherosclerosis risk factors, respectively）, without significant difference（χ^2 = 0.40, P = 0.9）. Intracranial arteries were mainly involved in cases without risk factors（75.0% vs. 31.3%; χ^2 = 4.11, P〈 0.05）. Rates of cerebral infarction history had no significant difference（12.5% vs. 50.0%; χ^2 = 3.2, P 〉0.05）. The percentage of neurosyphilis between two groups were not statistically significant（62.5% vs. 92.9%; χ^2 = 3.15, P 〉0.05）. Conclusions Patients of syphilis complicated with cerebral infarction without atherosclerosis risk factors were younger. Intracranial arteries were mainly involved in those patients.

关 键 词：梅毒 动脉粥样硬化 脑梗死 

分 类 号：R759.1[医药卫生—皮肤病学与性病学] R743.3[医药卫生—临床医学]