神经梅毒6例临床分析

目的通过研究分析神经梅毒临床及实验室检查的特点,提高对该病诊疗上的认识,为早期诊断提供依据。方法对6例符合神经梅毒诊断标准的患者,回顾性分析其临床特征、神经影像学和实验室检查资料。结果6例患者全为男性,年龄25～65岁,患梅毒性血管炎3例、麻痹性痴呆1例,梅毒性脑膜炎1例、脊髓梅毒1例;血清和脑脊液快速血浆反应素试验(RPR)和梅毒螺旋体血凝试验(TH-PA)均呈阳性;头颅CT显示大脑皮质梗死4例、颈动脉超声提示多发性血管炎;脑脊液检查2例呈炎性改变。结论神经梅毒分型不同、发病形式多样,早期误诊率较高,冶游史及血清、脑脊液梅毒抗体阳性可协助确诊,大剂量青霉素治疗有效。

Objective To study the clinical presentation of neurosyphilis for promotion the diagnosis and treatment of this disease. Methods：six patients with neurosyphilis were diagnosed and confirmed between 2006 and 2008 in our department, the data of clinical presentation and laboratory findings were analyzed retro- spectively, results： of 6 patients, the clinical manifestations of neurosyphilis are variable, the symptoms and signs test of syphilis abtibody in serum and CSF, examination os CSF, neuroimaging and epidemiologic data are necessary to diagnosis of neurosyphilis. The first choice of treatment is still high-dose intravenous penicillin G.