脑脊液梅毒加热甲苯胺红试验滴度转阴的麻痹性痴呆患者预后的影响因素  

Prognostic factors for the general paresis of the insane patients with negative cerebrospinalfluid syphilis heated toluidine red test titer

作　　者：张依 许东梅 ZHANG Yi;XU Dongmei(Beijing Ditan Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京地坛医院,北京100050

出　　处：《中国实用神经疾病杂志》2023年第7期815-818,共4页Chinese Journal of Practical Nervous Diseases

基　　金：首都医科大学附属北京地坛医院院内科研基金“启航计划”项目(编号:DTQH2016607)。

摘　　要：目的 分析脑脊液梅毒加热甲苯胺红试验(TRUST)滴度转阴的麻痹性痴呆患者预后的影响因素。方法 纳入38例脑脊液TRUST滴度经治疗后转阴的麻痹性痴呆患者,根据日常生活能力量表(ADL)和简易精神状态量表(MMSE)进行分组,比较2组患者的性别、年龄、文化程度、脑脊液TRUST滴度转阴时的血清TRUST滴度、脑脊液白细胞计数和蛋白定量以及头颅磁共振情况,分析上述指标与患者预后有无相关性。结果 患者预后与年龄、性别相关性不大,而与其文化程度存在一定相关性,预后良好组文化程度较高。2组血清TRUST滴度比较,差异无统计学意义(P=0.506)。2组白细胞计数、蛋白比较,差异均有统计学意义(P<0.001)。预后良好组头磁共振显示责任病灶的患者约占27.8%,预后不良组占40.0%,预后不良组高于预后良好组,但差异无统计学意义(P=0.833)。结论 麻痹性痴呆患者脑脊液TRUST滴度转阴并不代表预后良好,患者的预后还受文化程度、脑脊液白细胞计数、蛋白定量的影响。Objective To investigate the prognostic factors of general paresis of the insane(GPI)patients whose cerebrospinal fluid(CSF)syphilis heated toluidine red test(TRUST)titer turned negative.Methods A total of 38 GPI patients with TRUST titer in CSF negative after treatment were enrolled and divided into two groups accor⁃ding to the activities of daily living scale(ADL)and mini-mental state examination(MMSE).The gender,age,educa⁃tion level,serum TRUST titer when CSF TRUST titer turned negative,CSF white blood cell count and protein quantifi⁃cation,and head MRI were compared between the two groups.The correlation between these indicators and the prog⁃nosis of patients was analyzed.Results The prognosis of patients was not significantly correlated with age and gen⁃der,but it was correlated with education level,and the group with better prognosis had a higher education level.There was no significant difference in serum TRUST titer between the two groups(P=0.506).The white blood cell count and the protein were compared between the two groups(P<0.001).In the better prognosis group,the proportion of pa⁃tients with responsible lesions in head MRI was about 27.8%.The proportion of worse prognosis group was 40.0%,which was higher than that of better prognosis group,but the difference was not statistically significant(P=0.833).Conclusion Negative TRUST titer in CSF does not mean a better prognosis in patients with GPI.The prognosis is also affected by the patient􀆳s education level,white blood cell count,and protein quantification in CSF.

关 键 词：麻痹性痴呆 预后 TRUST滴度 白细胞计数 蛋白定量 脑脊液 血清 

分 类 号：R759.13[医药卫生—皮肤病学与性病学]