不同时期麻痹性痴呆临床对照研究

Clinical controlled study on general paresis of insane in different periods

目的:分析1947年至1966年和2004年至2007年两个不同历史时期麻痹性痴呆(GPI)患者的临床差异。方法:回顾性调查1947年6月至2007年6月GPI住院患者临床情况。病例分旧患者组(1947年至1966年时期247例中随机抽取50例),和新患者组(2004年至2007年期间,计12例)两组,进行对照分析。结果:旧患者组收治12.4例/年,新患者组3.42例/年;入院前和入院3d内作血液和脑脊液梅毒抗体检测旧患者组96%,新患者组为0%;临床误诊率旧患者组4%,新患者组100%;两组差异有显著性(P<0.01)。结论:目前GPI临床少见,患者性病冶游史隐蔽,临床血清梅毒的筛查未列为常规性检查,容易导致误诊。

Objective： To analyze the clinical distinction of general paresis of insane （GPI） inpatients of our hospital in two different historical periods, one from 1947 to 1966 and the other from 2004 to 2007. nethod：A retrospective survey was conducted focusing on clinical manifestation of GPI inpatients. The cases were divided into two groups according to their hospitalization periods, the old group （from 1947 to 1966 period, 50 cases randomly selected from 247 cases）and the new group （from 2004 to 2007 period, 12 cases）. A comparison was made between the two groups. Results： Number of inpatients per year of the old group was 12.4, but the new group only 3.42. Proportion of syphilis antibodies check in blood and cerebrospinal fluid before and after hospitalization within three days of the old group was 96% ,and the new group was 0%. Clinical misdiagnosis rate of the old group was 30% and the new group 100%. The differences of these factors were statistically significant between the two groups （ P 〈 0.01 ）. Conclusion ： For GPI was rare in clinic, sexual promiscuity history was concealed, and serum screening for syphilis had not classified as conventional inspection, it tend to misdiagnose GPI.