CAJ | 학술논문

目的分析有症状与无症状神经梅毒患者的临床及实验室特征。方法对33例确诊为神经梅毒的患者进行血液梅毒螺旋体明胶凝集试验（TPPA）、快速血浆反应素环状卡片试验（RPR）检测及脑脊液检测，对其临床及实验室特征进行回顾性分析。结果33例神经梅毒患者抗-HIV均为阴性，其中有症状神经梅毒患者22例（66.7%），无症状神经梅毒患者11例（33.3%）；有症状神经梅毒组脑脊液白细胞计数为（25.18±25.47）×106/L，异常率为68.2%（15/22），无症状神经梅毒组脑脊液白细胞计数为（21.09±21.49）×106/L，异常率为81.8%（9/11），二者差异无统计学意义（F=0.2432，P=0.6808）。有症状神经梅毒组患者脑脊液蛋白为（69.84±28.83）mg/dl，异常率为72.7%（16/22）；无症状神经梅毒组患者脑脊液蛋白为（43.75±19.6）mg/dl，异常率为18.2%（2/11），二者差异有显著统计学意义（F=0.0040，P=0.0078）。结论脑脊液蛋白异常可能与神经梅毒的发展及相关症状的发生存在一定相关性，而脑脊液白细胞的异常可能贯穿神经梅毒的全过程。
목적분석유증상여무증상신경매독환자적림상급실험실특정。방법대33례학진위신경매독적환자진행혈액매독라선체명효응집시험（TPPA）、쾌속혈장반응소배상잡편시험（RPR）검측급뇌척액검측，대기림상급실험실특정진행회고성분석。결과33례신경매독환자항-HIV균위음성，기중유증상신경매독환자22례（66.7%），무증상신경매독환자11례（33.3%）；유증상신경매독조뇌척액백세포계수위（25.18±25.47）×106/L，이상솔위68.2%（15/22），무증상신경매독조뇌척액백세포계수위（21.09±21.49）×106/L，이상솔위81.8%（9/11），이자차이무통계학의의（F=0.2432，P=0.6808）。유증상신경매독조환자뇌척액단백위（69.84±28.83）mg/dl，이상솔위72.7%（16/22）；무증상신경매독조환자뇌척액단백위（43.75±19.6）mg/dl，이상솔위18.2%（2/11），이자차이유현저통계학의의（F=0.0040，P=0.0078）。결론뇌척액단백이상가능여신경매독적발전급상관증상적발생존재일정상관성，이뇌척액백세포적이상가능관천신경매독적전과정。
Objective To analyze the clinical and laboratory characteristics in symptomatic neurosyphilis and asymptomatic neurosyphilis patients. Methods Total of 33 patients diagnosed as neurosyphilis received blood tests with treponema pallidum particle agglutination (TPPA), rapid plasma reagin circle card test (RPR) and cerebrospinal lfuid (CSF) examination in 2008-2012. Clinical and laboratory features of patients were ananlyzed, retrospectively. Results There were 22 cases with symptomatic neurosyphilis excluded HIV infection, with the cerebrospinal lfuid leukocyte as (25.18 ± 25.47) × 106/L and the abnormal rate as 68.2%(15/22). While for 11 cases with asymptomatic neurosyphilis, the cerebrospinal lfuid leukocyte was (21.09 ± 21.49) × 106/L and the abnormal rate was 81.8%(9/11). The cerebrospinal lfuid leukocyte count and its abnormal rate in two groups had no signiifcant differences (F=0.2432, P=0.6808). The cerebrospinal lfuid protein concentrations and abnormal rates between symptomatic neurosyphilis patients and asymptomatic neurosyphilis patients were (69.84 ± 28.83) mg/dl vs. (43.75 ± 19.6) mg/dl and 72.7%(16/22) vs. 18.2%(2/11), with signiifcant differences (F=0.0040, P=0.0078). Conclusions Abnormal CSF protein may be associated with the development and symptoms of neurosyphilis. While abnormal white blood cells in CSF may play a continuing role in the neurosyphilis progression.