有症状神经梅毒危险因素Logistic回归分析

Investigation on the risk factors of the symptomatic neurosyphilis by Logistic regression analysis

目的探讨发生症状性神经梅毒的危险因素。方法回顾性分析33例确诊的神经梅毒病例,从患者的年龄、性别、有无前期规范治疗、治疗前血清快速血浆反应素环状卡片试验(RPR)滴度、治疗前脑脊液RPR滴度、脑脊液常规、生化、颅内压力等方面,进行回顾性单因素条件Logistic回归分析。结果年龄、性别、治疗前血清RPR滴度、治疗前脑脊液RPR滴度、脑脊液白细胞数、颅内压力等方面差异均无统计学意义;前期规范治疗可以减少症状性神经梅毒的发生,脑脊液蛋白浓度与症状性神经梅毒的发生显著相关(χ2=4.9184,P=0.0266),为该疾病发生的危险因素;且脑脊液蛋白浓度,每升高1个单位,症状性神经梅毒的危险性可增加1.056倍。结论正规的治疗和随访可以减少症状性神经梅毒的发生;在神经梅毒的治疗、随访中,应特别注意脑脊液蛋白浓度的变化,其水平升高可能预示着症状性神经梅毒的发生。

Objective To investigate on the risk factors of association with the symptomatic neurosyphilis. Methods The clinical data of 33 patients with neurosyphilis were analyzed, retrospectively, including the age, sex, standardized treatment, serum rapid plasma reagin test （RPR） titer and RPR titer in cercbrospinal fluid before treatment, cerebrospinal fluid routine, biochemical and intracranial pressure, etc. Results There were no significant differences in age, gender, serum RPR titer, RPR titer in cerebrospinal fluid before treatment, cerebrospinal fluid white blood cell count and intracranial pressure. Standardized treatment could reduce the incidence of symptomatic neurosyphilis. There was a significant correlation between cerebrospinal fluid （CSF） protein concentration and the incidence of symptomatic neurosyphilis （x^2= 4.9184, P - 0.0266）. CSF protein concentration was a risk factor, and when it increases by one unit, symptomatic neurosyphilis could increase the risk of 1.056 times. Conclusions Regular treatment and follow-up could reduce the incidence of symptomatic neurosyphilis. In the course of neurosyphilis therapy and follow-up, we should pay particular attention to changes in cerebrospinal fluid protein concentration, which may indicate the occurrence of symptomatic neurosyphilis, when it is elevated.