摘要
目的探讨神经梅毒的临床表现、实验室检查和影像学检查特征。方法回顾性分析18例神经梅毒患者的临床表现、实验室检查和影像学检查资料。结果 18例神经梅毒患者平均发病年龄53.83岁,其中主质型8例(44.44%),其中麻痹性痴呆4例,脊髓痨3例,混合型1例;脑膜血管梅毒4例(22.22%);无症状型3例(16.67%);树胶样肿型2例(11.11%);脑膜炎型1例(5.56%)。血清血浆快速反应素试验(RPR)、梅毒螺旋体颗粒凝集试验(TPPA)检测均为阳性。脑脊液检查:18例患者TPPA均阳性,9例RPR阳性,9例脑脊液白细胞数≥10×106/L,7例脑脊液蛋白>0.50g/L。影像学表现为:脑梗死,脑萎缩,脑白质变性,额叶、颞叶、海马区异常信号及大脑后动脉闭塞,颅内动脉硬化。结论神经梅毒表现多样,临床体征、血清学、脑脊液及影像学对于诊断神经梅毒及分型有重要指导意义。
Objectives To explore the characteristics of clinical manifestation,laboratory examination and imageological examination of neurosyphilis. Methods The clinical manifestation,laboratory examination and imageological examination of 18 patients with neurosyphilis were retrospectively analyzed. Results The median attack age of 18 patients with neurosyphilis was 53. 83 years.Of all patients,8（ 44. 44%） were with parenchyma-type one,in which 4 with paralytic dementia,3 with locomotor ataxia and 1with mixed one; 4（ 22. 22%） had meningovascular syphilis; 3（ 16. 67%） with asymptomatic one; 2（ 11. 11%） with gumma-type one; and 1（ 5. 56%） with meningitis-type one. Serum and plasma rapid plasma regain test（ RPR） and treponema pallidum particle assay（ TPPA） all showed positive. Cerebrospinal fluid（ CSF） showed that all patients had positive TPPA but 9 had positive RPR,and 9 patients＇ CSF white blood cell count≥10 × 106/ L and 7 patients＇ CSF protein 0. 50 g / L. Imageological examination suggested cerebral infarction,encephalatrophy,white matter degeneration and abnormal signal of frontal lobe,temporal lobe and hippocampal areas as well as posterior cerebral artery occlusion and intracranial arteriosclerosis. Conclusions Neurosyphilis is diverse in manifestation,and clinical signs,serology,CSF and imageology are of great guiding significance in the diagnosis of neurosyphilis and its somatotypes.
出处
《中国老年保健医学》
2015年第5期80-82,共3页
Chinese Journal of Geriatric Care
关键词
神经梅毒
脑脊液
核磁共振
Neurosyphilis
Cerebrospinal fluid
Nuclear magnetic resonance
