隐性梅毒患者中神经梅毒患病率分析

Analysis on the prevalence of neurosyphilis in patients with latent syphilis

目的 探讨广州市神经梅毒流行情况,比较未经治疗隐性梅毒患者和血清固定的隐性梅毒患者中神经梅毒的患病率.方法 以横断面研究的方法,对初次诊断为隐性梅毒患者（未治疗或经治疗后出现血清固定）抽取脑脊液,进行性病研究实验室试验,筛查神经梅毒患者.结果 未经治疗隐性梅毒患者中有21.98%（60/273）为神经梅毒,其中10.99%（30/273）为无症状神经梅毒,10.99%（30/273）为有症状神经梅毒.经抗梅毒治疗血清固定隐性梅毒患者83例中1.20%（1/83）符合神经梅毒诊断,为无症状神经梅毒病例.在未经治疗隐性梅毒组中,无神经梅毒病例年龄与有神经梅毒病例年龄差异有统计学意义,前者年龄低于后者.结论 在抗梅毒治疗后产生梅毒血清固定患者神经梅毒发生的可能性相对未经治疗的隐性梅毒小,神经梅毒仍主要发生于未经治疗的潜伏梅毒人群中,提示未经治疗的隐性梅毒是神经梅毒发生的主要危险因素.

Objective To compare the prevalence of neurosyphilis in untreated patients with latent syphilis （LS） versus serofast patients treated for LS in Guangzhou City. Methods A cross-sectional study was performed. Cerebrospinal fluid was obtained from 356 patients who were first diagnosed with LS, and venereal disease research laboratory （VDRL） test was conducted to screen neurosyphilis. Results Among 273 untreated patients with LS, 60 （21.98%） were diagnosed with neurosyphilis, and of the 60 patients, 30 were asymptomatic , and the other 30 were symptomatic. In 83 serofast patients treated for LS, only 1 （ 1.2% ） was diagnosed with neurosyphilis, while no symptom was observed in this patient. In untreated cases of LS, the mean age was significantly lower in patients without neurosyphilis than in those with neurosyphilis.Conclusions Patients with untreated LS are more likely to develop neurosyphilis compared with serofast patients treated for LS, and neurosyphilis mainly occurs in untreated patients with LS, suggesting that untreated latent syphilis is an important risk factor for the development of neurosyphilis.