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[1]翁文佳,闫俊玲,高艳青.87 例神经梅毒患者临床及实验室特征分[J].传染病信息,2019,05:399-401+406.
 WENG Wen-jia,YAN Jun-ling,GAO Yan-qing*.Clinical and laboratory characteristics of 87 patients with neurosyphilis[J].Infectious Disease Information,2019,05:399-401+406.
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87 例神经梅毒患者临床及实验室特征分(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2019年05期
页码:
399-401+406
栏目:
论著
出版日期:
2019-11-13

文章信息/Info

Title:
Clinical and laboratory characteristics of 87 patients with neurosyphilis
文章编号:
1007-8134(2019)05-0399-04
作者:
翁文佳闫俊玲高艳青
 100069,首都医科大学附属北京佑安医院皮肤科(翁文佳、闫俊玲、高艳青)
Author(s):
WENG Wen-jia YAN Jun-ling GAO Yan-qing*
Department of Dermatology, Beijing You’an Hospital, Capital Medical University, 100069, China
关键词:
神经梅毒有症状无症状
Keywords:
neurosyphilis symptomatic asymptomatic
分类号:
R759.1
DOI:
10.3969/j.issn.1007-8134.2019.05.004
文献标识码:
A
摘要:
目的分析 87例神经梅毒患者的临床及实验室特征。方法回顾性总结分析 87例 HIV阴性的神经梅毒患者发病年龄、临床症状、脑脊液检查(包括脑脊液白细胞计数、蛋白定量)、快速血浆反应素环状卡片试验( rapid plasma reagent test, RPR)、梅毒螺旋体明胶颗粒凝集试验(treponema pallidum particle assay, TPPA)、梅毒荧光抗体吸收试验(?uorescent treponemal antibody absorption test, FTA-ABS)等资料。结果87例神经梅毒患者中有症状神经梅毒患者 54例(62.1%),其中眼部受损者最多见;无症状患者 33例(37.9%)。 87例患者中脑脊液白细胞异常率为 82.8%,脑脊液蛋白异常率为44.8%,脑脊液 RPR的异常率为 44.8%,脑脊液 TPPA阳性率为 80.5%,脑脊液 FTA-ABS IgG抗体阳性率为 87.4%、IgM抗体阳性率为 3.4%。有症状患者与无症状患者脑脊液 RPR、白细胞计数和蛋白定量,差异均无统计学意义( P均> 0.05)。有症状患者脑脊液 FTA-ABS IgG抗体阳性率为 94.4%,IgM抗体阳性率为 3.7%。结论有症状神经梅毒患者中眼部受损者多见,临床医生对有眼部损害的梅毒患者须警惕神经梅毒的可能。神经梅毒患者中脑脊液 RPR检测阳性率较低,脑脊液 RPR在诊断神经梅毒中的作用仍需要大样本研究进一步证实。有症状神经梅毒患者脑脊液 FTA-ABS抗体阴性不能排除神经梅毒。
Abstract:
ObjectiveTo analyze the clinical and laboratory features of neurosyphilis in 87 patients.Methods The onset age, clinical symptoms, cerebrospinal fluid examination (including cerebrospinal fluid white blood cell count, protein quantification), rapidplasma reagent test (RPR), treponema pallidum particle assay (TPPA) and fluorescent treponemal antibody absorption test (FTA-ABS) results of 87 HIV negative neurosyphilis patients were analyzed, retrospectively. ResultsAmong 87 patients, 54 cases (62.1%) hadsymptomatic neurosyphilis and ocular lesions were dominant, and 33 cases (37.9%) had asymptomatic neurosyphilis. The cerebrospinal fluid leukocyte abnormal rate was 82.8%, cerebrospinal fluid protein abnormal rate was 44.8%; cerebrospinal fluid RPR abnormal rate was 44.8%, cerebrospinal fluid TPPA positive rate was 80.5%, cerebrospinal fluid FTA-ABS IgG antibody positive rate was 87.4%, and IgM antibody positive rate was 3.4%. There were no significant differences in RPR, white blood cell count and protein quantificationbetween symptomatic patients and asymptomatic patients (P> 0.05). The positive rate of FTA-ABS IgG antibody was 94.4% andthe positive rate of IgM antibody was 3.7% in patients with symptomatic neurosyphilis. ConclusionsThe patients with symptomaticneurosyphilis are prone to have ocular damage. Clinicians should be alert to the possibility of neurosyphilis in syphilis patients withocular damage. The positive rate of cerebrospinal fluid RPR test in patients with neurosyphilis is low. The role of cerebrospinal fluidRPR in the diagnosis of neurosyphilis still requires large-sample study for further confirmation. Neurosyphilis can not be ruled out forsymptomatic neurosyphilis patients with negative FTA-ABS antibody.

参考文献/References

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备注/Memo

备注/Memo:
[基金项目]北京市医院管理局青苗人才培养计划(QML20181701)
[作者单位]100069,首都医科大学附属北京佑安医院皮肤科 (翁文佳、闫俊玲、高艳青)
[通信作者]高艳青,E-mail:gyqing2001bj@sina.com
*Correspondingauthor,E-mail:gyqing2001bj@sina.com
更新日期/Last Update: 2019-11-13