头孢曲松治疗HIV阴性无症状神经梅毒后实验室指标的变化  

Laboratory characteristics of HIV-negative patients with asymptomatic neurosyphilis after ceftriaxone treatment

作　　者：翁文佳 闫俊玲[1] 高艳青[1] WENG Wenjia;YAN Junling;GAO Yanqing(Department of Dermatology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院皮肤科

出　　处：《中国麻风皮肤病杂志》2019年第11期667-669,共3页China Journal of Leprosy and Skin Diseases

基　　金：北京市医院管理中心“青苗”计划专项经费资助(编号:QML20181701)

摘　　要：目的:检测无症状神经梅毒患者治疗前后血液、脑脊液(CSF)相关指标的变化,探讨其对预后的意义。方法:回顾性分析2016年3月至2018年12月于我科确诊并治疗的34例无症状神经梅毒患者的一般资料及相关实验室检查:包括血液快速血浆反应素环状卡片试验(RPR)、脑脊液白细胞(CSF-WBC)、蛋白量(CSF-PRO)、CSF-RPR、脑脊液梅毒螺旋体明胶颗粒凝集试验(CSF-TPPA)。结果:经过1个疗程头孢曲松钠驱梅治疗,治疗前及治疗后脑脊液白细胞中位数(四分位数)分别为0.0105(0.0068,0.022)和0.005(0.0028,0.0105),差异有统计学意义(Z=-2.738,P=0.005);脑脊液蛋白中位数(四分位数)分别为0.3(0.155,0.485)和0.16(0.13,0.245),差异有统计学意义(Z=-2.092,P=0.036);与治疗前相比,治疗后3个月、6个月、12个月时血RPR下降≥4倍者分别为6例(17.65%)、9例(26.47%)和16例(47.06%)。结论:头孢曲松钠治疗后,脑脊液白细胞下降及蛋白下降,对于无法行腰椎穿刺的患者,可通过血RPR下降≥4倍来初步评价疗效。Objective:To detect the changes of indexes in blood and cerebrospinal fluid(CSF)before and after ceftriaxone treatment in HIV-negative patients with asymptomatic neurosyphilis and investigate the significance of prognosis.Methods:The clinical and laboratory test data of 34 patients with asymptomatic neurosyphilis in our department from March 2016 to December 2018 was analyzed,including serum-rapid plasma reagin test(RPR),CSF-leukocytes、CSF-protein amount,CSF-RPR,treponemalpallidumparticleag-glutination(TPPA).Results:After 1 course of treatment with ceftriaxone sodium,the median(quartile)of CSF leukocytes and cerebrospinal fluid protein were 0.005(0.0028,0.0105)and 0.16(0.13,0.245),which were lower than those before treatment 0.0105(0.0068,0.022),and 0.3(0.155,0.485),with significant differences(P s<0.005).Compared with before treatment,the blood RPR decreased by≥4 times at 3 months,6 months,and 12 months after treatment in 6(17.65%),9(26.47%),and 16 cases(47.06%),respectively.Conclusion:After treatment with ceftriaxone sodium,If the level of leukocyte and protein of CSF decreases and the blood RPR decreases by≥4 times,we can preliminarily predict that the patient is cured.

关 键 词：无症状神经梅毒 实验室特征 

分 类 号：R75[医药卫生—皮肤病学与性病学]