苄星青霉素对神经梅毒患者脑脊液检测指标的影响

The influence of benzathine penicillin on the cerebrospinal fluid indexes in patients with neurosyphilis

目的通过对接受苄星青霉素治疗和未治疗的神经梅毒患者的血清及脑脊液检测指标进行对比,探讨苄星青霉素治疗对神经梅毒诊断的影响。方法将2010年10月至2021年3月于首都医科大学附属北京地坛医院神经内科住院的所有神经梅毒患者,按是否使用苄星青霉素将患者分为治疗组和未治疗组。对两组患者血清及脑脊液(CSF)检测指标进行对比分析。结果未治疗组中有症状病例比例(93.4%)及CSF-TRUST阳性率(82.6%)显著高于治疗组(37.9%,58.0%),P均<0.001。治疗组CSF蛋白含量异常率(42.5%)、白细胞计数(10.5个/μL)及蛋白含量值(38.6 mg/dL)均显著低于未治疗组(74.3%,33个/μL,64.4 mg/dL),P均<0.001。结论苄星青霉素可对神经梅毒患者实验室检测指标产生一定影响进而增加此类患者的诊断难度。

Objective:To investigate the influence of benzathine penicillin on the diagnosis of neurosyphilis by comparing the serum and cerebrospinal fluid(CSF)test indexes between treated and untreated patients.Methods All patients who were hospitalized in the Department of Neurology,Beijing Ditan Hospital,and diagnosed with neurosyphilis between October 2010 and March 2021 were enrolled.Patients were divided into treated and untreated groups according to whether benzathine penicillin was used.The serum and cerebrospinal fluid(CSF)test indexes of the two groups were compared and analyzed.Results The proportion of symptomatic cases and positivity rate of CSF-TRUST in untreated patients were 93.4%and 82.6%,respectively,significantly higher than those in treated patients(37.9%and 58.0%,P all<0.001).The abnormality rate of CSF protein content,leukocyte count,and protein content were significantly lower than the figures in untreated patients(42.5%vs 74.3%,10.5 cell/μL vs 33 cell/μL,38.6 mg/dL vs 64.4 mg/dL,P all<0.001).Conclusion Benzathine penicillin can affect the laboratory indicators of neurosyphilis patients and thus increase the difficulty of diagnosis among these patients.