CAJ | 학술논문

目的探讨以痴呆为突出表现的神经梅毒的临床特征及其治疗方法和预后,以期提高对该病的诊治水平.方法计算机检索中国生物医学文献数据库(CBM)和Medline,对1989年至今国内外文献中公开发表的以痴呆为突出表现的梅毒患者的病历资料(病例报告形式)进行回顾性分析.结果纳入44篇文献共62例患者(6)例麻痹性痴呆及1例梅毒性精神神经病患者),其临床特征包括:(1)男性多见;(2)多数隐匿起病;(3)首发症状以记忆力减退和性格改变多见;(4)MRI、CT以脑萎缩为主;(5)血清、CSF梅毒抗体检查阳性,也可有特殊情况;(6)确诊较困难;(7)驱梅治疗近期症状可不同程度改善;(8)远期预后证据缺乏.结论 (1)麻痹性痴呆和梅毒性精神神经病均可有痴呆表现;(2)原因不明的痴呆患者应常规行梅毒血清学及脑脊液检查;(3)驱梅结合对症治疗大多近期疗效好;(4)需长期随访观察远期疗效.
목적 탐토이치태위돌출표현적신경매독적림상특정급기치료방법화예후,이기제고대해병적진치수평.방법 계산궤검색중국생물의학문헌수거고(CBM)화Medline,대1989년지금국내외문헌중공개발표적이치태위돌출표현적매독환자적병력자료(병례보고형식)진행회고성분석.결과 납입44편문헌공62례환자(6)례마비성치태급1례매독성정신신경병환자),기림상특정포괄:(1)남성다견;(2)다수은닉기병;(3)수발증상이기억력감퇴화성격개변다견;(4)MRI、CT이뇌위축위주;(5)혈청、CSF매독항체검사양성,야가유특수정황;(6)학진교곤난;(7)구매치료근기증상가불동정도개선;(8)원기예후증거결핍.결론 (1)마비성치태화매독성정신신경병균가유치태표현;(2)원인불명적치태환자응상규행매독혈청학급뇌척액검사;(3)구매결합대증치료대다근기료효호;(4)수장기수방관찰원기료효.
Objective To study the clinical features, therapy and prognosis of neurosyphilis typically manifested as dementia to improve its diagnosis and treatment. Methods A retrospective analysis of patients with neurosyphilis typically manifested as dementia, searched in Medline and Chinese Biomedical Literature Datebase (CBM) from 1989 to 2010, was performed. Results Forty-four studies involving 62 patients (61 cases of general paresis and 1 case of syphilitic psychoneurosis) were evaluated;the clinical features of them included the follows: male are more common;most of them had insidious onset;memory impairment and personality changes were the first common symptoms;diffuse cerebral atrophy was found in MRI and CT;serum and cerebrospinal fluid (CSF) syphilis antibody reaction was positive with some exceptional case;definite diagnosis was difficult;after anti-syphilitic therapy, symptoms could be improved more or less in a short time;and evidence of long-term prognosis was insufficient. Conclusion Both general paresis and syphilitic psychoneurosis could cause dementia. Dementia patients should be given serum and CSF syphilis antibody examination routinely if the causes of dementia are unknown. Anti-syphilitic and symptomatic treatments mostly enjoy good curative effects in a short term. Close follow-up is necessary in observing the forward effects.