30例神经梅毒的临床分析报告

Clinical analysis on 30 cases with neurosyphilis

目的：通过研究神经梅毒临床表现,提高对该病诊疗上的认识。方法：对我院及上海华山医院2000-2007年诊治的30例神经梅毒进行回顾性分析。结果：30例头颅CT和MRI均有脑萎缩、梗死或脱髓鞘病变等改变;脑脊液快速血浆反应素试验（CSF-RPR）阳性率80%,脑脊液梅毒螺旋体抗原凝集试验（CSF-TPPA）96.7%阳性;脑脊液检查蛋白增高阳性率66.7%,细胞数增高阳性率53.3%。结论：脑脊液TPPA检测有助于神经梅毒的诊断,无症状神经梅毒的脑脊液TPPA检测也可以呈阳性结果。脑脊液白细胞计数与蛋白含量是监测神经梅毒疗效的较敏感指标。

Objective：To study the clinical presentation of neurosyphilis for promoting the diagnosis and treatment of this disease.Methods：Thirty patients with neurosyphilis were diagnosed and confirmed between 2000 and 2007 in our hospital and Huashan Hospital of Shanghai.The data of clinical presentation and laboratory findings were analyzed retrospectively.Results：Of 30 patients,changes of cerebral atrophy,infarction and demyelination were seen in CT and MRI of cranium screening.80% of them were positive for rapid plasma regain test（RPR） and 96.7%,positive for treponema pallidum particle assay（TPPA）on the cerebrospinal fluid.The cerebrospinal fluid protein increased in 66.7% and white cell count increased in 53.3% of the cases.Conclusion：Detection of TPPA in CSF is helpful in diagnosing neurosyphilis,even though TPPA in CSF may be positive in patients with asymptomatic neurosyphilis.The white cell count and protein of cerebrospinal fluid are important indicators in evaluating the results of neurosyphilis treatment.