摘要
目的:总结神经梅毒的临床特点及诊断。方法:通过收集3例神经梅毒的临床资料,并检索中国生物医学文献、维普、万方等数据库1994-2014年在核心期刊公开发表的关于神经梅毒文献进行回顾分析。结果:纳入133篇,1 208例病人(不包含本文3例),男971例(80.38%),女237例(19.62%),男女比例4∶1;年龄15~80岁,60岁以上126例(10.43%)。有冶游史(包括配偶)634例(52.48%),合并人类免疫缺陷病毒阳性16例(1.32%),误诊635例(52.57%)。临床分型包括无症状型80例(6.62%),脑(脊)膜型149例(12.33%),脑(脊)膜血管型389例(32.20%),麻痹性痴呆457例(37.83%),脊髓痨94例(7.78%),树胶样肿16例(1.32%),混合型22例(1.82%),特殊类型(腓总神经梅毒)1例(0.08%)。结论:神经梅毒多发于青中年男性,临床表现多样,误诊率高,诊断主要靠血清学、脑脊液检查,影像学及电生理检查等无特异性。
Objective:To summarize the clinical characteristics and diagnosis of neurosyphilis. Methods:The clinical data of 3 patients with neurosyphilis were retrospectively analyzed. The literatures about neurosyphilis from in CNKI,VIP and Wanfang database were searched,and these literatures were published in Chinese Sci-tech Core Periodicals from 1994 to 2014. Results:One hundred and thirty-three literatures(1208 patients) were identified,1028 patients(without 3 patients in this article) included 971 male cases (80. 38%) and 237 female cases (19. 62%) and the ratio of male to female was 4:1. The patients age was from 15 to 80 years old, and the patients over 60 years old was 126 cases(10. 43%). The patients with play history(including spouse) in 634 cases (52.48%),HIV infection in 16 cases(1. 32%),and misdiagnosis in 635 cases(52. 57%) were found. The asymptomatic type neurosyphilis in 80 cases(6. 62%),meningeal(spinal) type neurosyphilis in 149 cases(12. 33%),meningovascular(spinal) type neurosyphilis in 389 cases(32. 20%),paralytic dementia in 457 cases(37. 83%),tabesdorsalis in 94 cases(7. 78%),syphilitic gumma in 16 cases(1.32%),mixed type in 22 cases(1. 82%) and special type(common peroneal nerve neurosyphilis) in 1 case (0. 08%) were identified. Conclusions:Neurosyphilis is often found in young and middle-aged men with various clinical manifestations and high misdiagnosis rate, which can mainly be diagnosed by serum and cerebrospinal fluid examination. The imaging and electrophysiological examinations are not specific.
出处
《蚌埠医学院学报》
CAS
2017年第8期1073-1075,1079,共4页
Journal of Bengbu Medical College
关键词
神经梅毒
临床表现
诊断
neurosyphilis
clinical manifestations
diagnosis