认知障碍对神经梅毒患者临床特征与头颅磁共振结果影响的研究  

Clinical analysis and magnetic resonance features of neurosyphilis with cognitive impairment

作　　者：罗容 侍海存 Rong LUO;Haicun SHI(TheYancheng Schoolof Clinical Medicine of Nanjing Medical University Yancheng Third People's Hospital,Yancheng 224001,Jiangsu,China)

机构地区：[1]南京医科大学盐城临床医学院盐城市第三人民医院神经内科,江苏盐城224001

出　　处：《阿尔茨海默病及相关病杂志》2024年第4期273-276,共4页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：2021年度江苏医药职业学院临床学院专项科研发展基金。

摘　　要：目的:分析伴认知障碍的神经梅毒患者的临床资料、实验室检查和影像学特点。方法:回顾性分析2018年1月至2023年2月在盐城市第三人民医院神经内科住院首次确诊的有临床症状的神经梅毒患者,根据认知评分分为认知障碍组(cognitive impairment,CI)和非认知障碍组(non-cognitive impairment,n-CI)。分析患者的一般资料,血清和脑脊液梅毒抗体检查、头颅磁共振等资料。结果:共纳入21例神经梅毒患者,其中认知障碍组11例,非认知障碍组10例。两组患者在性别、年龄、受教育年限、高血压病、2型糖尿病、吸烟饮酒史、冶游史、合并精神行为异常方面比较差异无统计学意义(P>0.05)。CI组发病至就诊明显时间长于n-CI组(10.90±7.43m vs 0),差异具有统计学意义(P<0.05)。CI组的全脑萎缩评分≥1分的比例(100%vs 30%)、内侧颞叶评分≥1分的比例(90.09%vs 30%)、Fazekas分级≥2分的比例(90.09%vs 20%)、侧脑室扩大的比例(63.64%vs 10%)均高于n-CI组,差异有统计学意义(P<0.05)。结论:中老年男性,以慢性进行性记忆力减退伴精神行为异常是伴认知障碍神经梅毒的临床特点,全脑皮质萎缩是伴认知障碍神经梅毒的影像学特点。Objective:To analyze the clinical data,laboratory tests,and imaging characteristics of neurosyphilis with cognitive impairment.Methods:Retrospective analysis of neurosyphilis patients who were first diagnosed with clinical symptoms in the neurology department of the Third People's Hospital of Yancheng City from January 2018 to February 2023.They were divided into cognitive impairment group(CI)and non cognitive impairment group(n-CI)based on cognitive scores.Analyze the patient's general information,serum and cerebrospinal fluid syphilis antibody tests,and cranial magnetic resonance imaging.Results:A total of 21 neurosyphilis patients were included,including 11 in the cognitive impairment group and 10 in the non-cognitive impairment group.There was no significant difference between the two groups in gender,age,years of education,hypertension,type 2 diabetes,smoking and drinking history,entertainment history,and mental and behavioral abnormalities(P>0.05).The time from onset to treatment in the CI group was significantly longer than that in the n-CI group(10.90±7.43m vs 0),and the difference was statistically significant(P<0.05).The proportion of CI group with global brain atrophy score≥1 point(100%vs 30%),medial temporal lobe score≥1 point(90.09%vs 30%),Fazekas grade≥2 point(90.09%vs 20%),and lateral ventricular enlargement rate(63.64%vs 10%)were all higher than those of n-CI group,and the differences were statistically significant(P<0.05).Conclusion:Chronic progressive memory impairment with abnormal mental behavior is a clinical characteristic of neurosyphilis with cognitive impairment in middle-aged and elderly men;Whole cerebral cortical atrophy is an imaging characteristic of neurosyphilis with cognitive impairment.

关 键 词：神经梅毒 认知障碍 全脑萎缩 

分 类 号：R742[医药卫生—神经病学与精神病学]