已治隐性梅毒患者脑脊液梅毒抗体检测及评价

The Detection and Evaluation of Treponemal Antibody in CSF of Patients with Treated Latent Syphilis

目的 :观察经过驱梅治疗但 RPR持续阳性 2 a以上的隐性梅毒患者是否存在无症状神经梅毒。方法 :对 2 5例患者进行脑脊液常规及梅毒抗体检测。结果 :6 4 %蛋白升高、36 %葡萄糖升高 ;2 8%患者脑脊液存在梅毒抗体 ,其中VDRL、FTA- Abs、TPHA阳性者分别为 :1、2、7例 ,3种方法检出差异有显著性 (P<0 .0 5 )。结论 :本组患者部分存在无症状神经梅毒 ,可能是梅毒患者治疗困难 ,RPR持续阳性的原因之一。以 VDRL阳性作为无症状神经梅毒的唯一诊断标准 ,大部分患者将被漏诊。

Objective:To observe whether there was asymptomatic neurosyphilis in treated latent syphilis with persisting positive RPR(more than two year ) who have no neurologic symptoms.Methods:Routine test and treponemal antibodies were measured in cerebrospinal fluid(CSF) of these 25 patients.Results:26(64%) had mildly elevated protein concentration and 9(36%)glucose concentration in CSF. Treponemal antibodies test: 7 (28%) had treponemal antibodies in CSF : 1(4%)VDRL,2(8%)FTA-Abs,7(28%)TPHA were positive; there were significantly differences among these treponemal antibodies in CSF(P<0.05).Conclusions:The results indicated there could be an asymptomatic neurosyphilis in these patients partly and could be one of the reasons with persisting positive RPR and very diffcult to antisyphilitic threapy. If VDRL postive in CSF was considered as the only diagnostic criteria of asymptomatic neurosyphilis, most of these patients would be missed.