梅毒患者脑脊液检测的意义

Significance of cerebrospinal fluid test in patients with syphilis

目的 : 观察梅毒患者无症状神经梅毒发生情况 ,并探讨其意义。方法 : 对 12 6例HIV阴性梅毒患者的脑脊液进行常规、梅毒暗视野检查、聚合酶链反应 (PCR)及梅毒抗体检测。结果 : 在 12 6例患者脑脊液中 ,常规检测发现 82例 (6 5 .0 8% )蛋白升高 ,4 1例 (32 .5 4 % )葡萄糖升高 ,未发现红细胞和白细胞 ;TP -PCR及梅毒暗视野检查均阴性 ;有 4 2例 (33.33% )梅毒患者脑脊液至少存在一种至一种以上梅毒抗体。结论 : 梅毒患者脑脊液存在异常 ,未经治疗梅毒患者脑脊液梅毒抗体检出率 ,高于经数疗程驱梅治疗但RPR持续阳性一年以上梅毒患者脑脊液梅毒抗体检出率。表明部分患者存在无症状神经梅毒 ,并可能与RPR持续阳性有关。

Objective:To determine the proportion of asy mptomatic neurosyphilis in syphilis patients who had no neurologic symptoms and to explore its significance. Methods:Cerebrospinal fluid cel l count and protein,TP-PCR and TP-darkfield microscopic examination were perfor med in 126 syphilis patients with negative HIV sera. RPR,IgM,VDRL,TPPA and FT A-ABS were tested. Results: In cerebrospinal fluid (CSF) o f the 126 patients,82 ( 65.08% ) had mildly elevated protein level and 41 (32 .54% ) glucose level. No red cells and white cells were found. TP-PCR and TP-darkfiel d microscopic examination were negative. Forty-two (33.33%) patients had one or more treponema antibodies in CSF. Conclusion :There wer e CSF abnormalities in syphilis patients. The positivity rate of treponema antib odies in CSF of untreated patients was higher than that in treated patients. The results indicate there may be an asymptomatic neurosyphilis in part of these pa tients,which is associated with persisting positive RPR.