摘要
目的探讨神经梅毒的临床表现及诊治方法。方法分析38例神经梅毒患者的临床资料。结果38例患者包括无症状型2例，脑膜炎型3例，脑膜血管型16例，麻痹性痴呆型13例，脊髓痨型4例。38例患者血快速血浆反应素试验（RPRT）、梅毒螺旋体血凝试验（TPHA）及脑脊液TPHA均阳性；脑脊液RPRT检查33例（86．84％，33／38）阳性，5例（13．16％，5／38）阴性。经治疗所有患者临床症状均缓解；血和脑脊液RPRT比治疗前降低，但未转阴；13例（34．21％，13／38）脑脊液白细胞及蛋白含量正常。随访6个月，17例（44．74％，17／38）血和脑脊液RPRT转阴，其余均有不同程度下降；33例（86．84％，33／38）脑脊液白细胞及蛋白含量正常。结论神经梅毒临床症状复杂，容易误漏诊；血及脑脊液检查是诊断的必要依据；青霉素是首选的治疗药物；脑脊液白细胞与蛋白含量是重要的疗效指标。
Objective To explore the clinical features,diagnosis and treatment of neurosyphilis. Methods The clinical data of 38 patients with neurosyphilis were analyzed. Results Among the 38 patients,2 eases were asymptomatic neurosyphilis,3 cases were syphilitic meningitis,16 cases were meningovascular syphilis, 13 cases were paralytic dementia,and 4 cases were spinal tuberculosis. All 38 patients were positive in rapid plasma reagin test （RPRT） ,treponema pallidum hemagglutination assay （TPHA） of blood and TPHA of cerebrospinal fluid, 32 cases （86.84%, 33/38 ） were positive in RPRT of cerebrospinal fluid, and 5 cases （13.16%, 5/38 ） were negative in RPRT of cerebrospinal fluid. All patients were improved in clinical symptom after treatment. RPRT of blood and cerebrospinal fluid were decreased butstill positive,and the leukocyte and protein concentrations of cerebrospinal fluid were normal in 13 cases （34.21%, 13/38）. Six months after treatment,RPRT of blood and cerebrospinal fluid were negative in 17 cases （44.74%, 17/38 ）. The leukocyte and protein concentrations of eerebrospmal fluid were normal in 33 cases （86.84% ,33/38）. Conclusions Clinical manifestation of neurosyphilis is variety,and easily misdiagnosed. Syphilis examination in blood and cerebrospinal fluid is the necessary basis for diagnosis. Penicillin is the drug of first choice for the treatment. Cerebrospinal fluid leukocyte and protein concentrations are sensitive indicators to monitor the effect.
出处
《中国医师进修杂志》
2014年第19期36-38,共3页
Chinese Journal of Postgraduates of Medicine
关键词
神经梅毒
体征和症状
诊断
治疗
Neurosyphilis
Signs and symptoms
Diagnosis
Therapy
