早期梅毒患者血清甲苯胺红不加热血清试验滴度与神经梅毒发生的相关性分析

Correlation between serum TRUST titer of early syphilis and neurosyphilis

目的分析早期梅毒患者血清甲苯胺红不加热血清试验(TRUST)滴度与神经梅毒发生的相关性。方法选取2016年1月至2020年12月广西医科大学第一附属医院收治的103例早期梅毒患者作为研究对象,根据后期病情发展分为神经梅毒组(n=51)和非神经梅毒组(n=52)。对两组患者进行实验室检测,并开展统计学比较。结果103例早期梅毒患者行梅毒血清学检测,血清TRUST滴度≥1∶32共有36例,其中神经梅毒组30例(58.8%),非神经梅毒组6例(11.5%),两组比较差异具有统计学意义(P=0.000)。对神经梅毒组患者的脑脊液检测结果进行分析,梅毒螺旋体颗粒凝集试验(TPPA)阳性患者50例,TRUST阳性患者33例,蛋白量升高患者27例,白细胞计数升高患者29例,脑脊液蛋白量和白细胞计数均升高患者15例;当确诊神经梅毒患者的脑脊液检测结果为阳性/异常时,其梅毒早期血清学TRUST滴度≥1∶32的占比偏高。结论早期梅毒血清TRUST滴度≥1∶32的患者神经梅毒发生风险高,因此针对这类患者应尽早接受脑脊液检测并积极接受相关治疗,避免病情进一步发展。

Objective To analyze the correlation of serum toluidine red unheated serum test(TRUST)titer and neurosyphilis occurrence in early syphilis patients.Methods A total of 103 early syphilis patients admitted to the First Affiliated Hospital of Guangxi Medical University from January 2016 to December 2020 were selected as the research subjects and divided into neurosyphilis group(n=51)and non-neurosyphilis group(n=52)according to the later disease development.Laboratory tests were performed,and statistical comparisons were performed.Results 103 patients with early syphilis underwent syphilis serological testing,and 36 serum TRUST titers≥1∶32,including 30 neurosyphilis(58.8%)and 6 non-neurosyphilis(11.5%),the difference between the two groups was statistically significant(P=0.000).Analysis of the cerebrospinal fluid(CSF)test results of neurosyphilis patients with syphilis,50 patients with treponema particle agglutination test(TPPA)positive,33 patients with TRUST positive,27 patients with elevated protein,29 patients with elevated leukocyte count,15 patients with elevated CSF protein and white blood cell count.When the CSF test results of confirmed neurosyphilis is positive/abnormal,the proportion of early syphilis serum TRUST titer≥1∶32.Conclusions Patients with early syphilis serum TRUST titer of≥1∶32 have a high risk of neurosyphilis.Therefore,such patients should receive CSF test as soon as possible and actively receive relevant treatment to avoid further development of the disease.