伴有症状的神经梅毒9例临床特点和诊治

The Clinical Features,Diagnosis and Treatment of Nine Cases of Neurosyphilis with Clinical Symptoms

目的探讨神经梅毒的临床特征、诊断及治疗。方法回顾性分析本院神经内科2006年1月-2010年12月收治的9例伴有症状的神经梅毒患者临床资料并结合文献讨论分析。结果本组伴有临床症状的神经梅毒中,4例麻痹性痴呆,3例脑膜神经梅毒,1例脑膜血管梅毒,1例脊髓膜血管梅毒;均给予水剂青霉素G治疗;于治疗后6个月,12个月,24个月随访,6例患者临床症状好转,程度不一,2例患者失访,1例死亡。结论神经梅毒的临床表现复杂多样,诊断应结合病史、临床表现、实验室检查综合分析;治疗以青霉素为首选。

Objective To investigate clinical features,diagnosis and treatment of neurosyphilis.Methods The clinical data of 9 patients with concomitant symptomatic neurosyphilis who were hospitalized from January 2006 to December 2010 was collected for retrospective analysis of clinical manifestation,auxiliary examination,diagnosis and treatment.Results The patients were manifest in clinical symptoms of neurosyphilis,including 4 cases of paralytic dementia,3 cases of meningeal neurosyphilis,1 case of meningeal vascular syphilis,and 1 case of spinal cord membranes vascular syphilis.All of the patients were given aqueous penicillin G.Clinical and serologic evaluation were performed 6 months,12 months and 24 months after treatment.Six patients with clinical symptoms improved,but to various degrees,2 patients were lost,1 patient died.Conclusion The clinical presentation of neurosyphilis is varied.History,clinical features and auxiliary examination are helpful to diagnosis and treatment.