66例神经梅毒患者的临床分析  

Clinical analysis of 66 cases with neurosyphilis

作　　者：李莹洁 王晓杰 殷文浩 LI Yingjie;WANG Xiaojie;YIN Wenhao(Department of Dermatology and Venereology,Affiliated Hospital of Jiaxing University(the First Hospital of Jiaxing),Jiaxing 314000,Zhejiang,China)

机构地区：[1]嘉兴学院附属医院(嘉兴市第一医院)皮肤科,浙江嘉兴314000

出　　处：《中国性科学》2023年第7期145-148,共4页Chinese Journal of Human Sexuality

基　　金：嘉兴市中医药重点学科项目-中西医结合皮肤病与性病学(2019XK-C06)。

摘　　要：目的分析神经梅毒的临床症状及实验室检查结果,探讨其相关影响因素。方法收集2016年1月至2022年6月嘉兴市第一医院确诊的神经梅毒病例,对其临床资料进行回顾性分析。结果共纳入66例神经梅毒患者,其中男48例,女18例,血清甲苯胺红不加热血清试验(TRUST)滴度≥1∶64组症状性神经梅毒发生率高于TRUST滴度1∶8~1∶32组(χ^(2)=4.974,P=0.025);症状性神经梅毒脑脊液蛋白定量均升高,其中脑膜血管型和脑实质型蛋白含量显著高于无症状型(P<0.05)。脑实质型脑脊液白蛋白定量、免疫球蛋白(Ig)A和IgM异常率显著高于无症状型,脑膜血管型脑脊液IgM异常率高于无症状型(P<0.05)。结论TRUST滴度高者更易发展为症状型神经梅毒,脑脊液蛋白含量可作为神经梅毒诊断和病情评估的参考指标,脑脊液Ig也可辅助神经梅毒的分型和诊断。Objective To investigate the clinical symptoms and laboratory examination of neurosyphilis and analyze the related factors.Methods The clinical data of patients with neurosyphilis from January 2016 to June 2022 was collected and retrospectively analyzed.Results A total of 66 patients were collected,including 48 males and 18 females.The incidence of symptomatic neurosyphilis was higher in toluidine red unheated serum test(TRUST)titer≥1∶64 group than that in TRUST titer 1∶8-1∶32 group(χ^(2)=4.974,P=0.025).The level of Cerebrospinal Fluid(CSF)protein in symptomatic neurosyphilis were all elevated.It was significantly higher in meningovascular neurosyphilis and cerebral parenchymal syphilis than that in asymptomatic neurosyphilis(P<0.05).The level of CSF albumin,abnormal rate of immune globulin A(IgA)and immune globulin M(IgM)were higher in cerebral parenchymal syphilis than that in asymptomatic neurosyphilis.Abnormal rate of IgM was were higher in meningovascular neurosyphilis than that in asymptomatic neurosyphilis(P<0.05).Conclusions Patients with high TRUST titer are more likely to develop symptomatic neurosyphilis.The level of CSF protein can be used as a reference index for the diagnosis and severity evaluation of neurosyphilis.CSF immunoglobulin can also assist the classification and diagnosis of neurosyphilis.

关 键 词：神经梅毒 脑脊液 甲苯胺红不加热血清试验滴度 

分 类 号：R759[医药卫生—皮肤病学与性病学]