CAJ | 학술논문

目的：探讨未经治疗的早期梅毒脑脊液各项检测的意义及其对神经梅毒的诊断价值。方法：对129例未经治疗的早期梅毒患者脑脊液进行细胞计数和蛋白定量、VDRL、FTA-ABS、RPR、TPPA检测以及RT-PCR检测TP，并分析不同RPR滴度组及不同RT-PCR结果组脑脊液异常率的差异。结果：脑脊液细胞或蛋白异常者30例（23.26％），VDRL阳性2例（1.55％），FTA-ABS阳性3例（2.33％），RPR阳性5例（3.88％），TPPA阳性10例（7.75％），RT-PCR阳性32例（24.81％）。2例（1.55％）确诊为神经梅毒。血清RPR滴度≤1∶16组与≥1∶32组患者 CSF 异常率差异有统计学意义（χ2＝8.37， P ＝0.004）。脑脊液RT-PCR检测阳性与阴性组脑脊液异常率差异有统计学意义（χ2＝4.49，P＝0.034）。结论：血清RPR滴度≥1∶32者脑脊液异常率较高，临床中应引起重视。单纯对于未经治疗的早期梅毒而言，用PCR检测脑脊液中TP含量的方法对神经梅毒的诊断不具有明显价值。
목적：탐토미경치료적조기매독뇌척액각항검측적의의급기대신경매독적진단개치。방법：대129례미경치료적조기매독환자뇌척액진행세포계수화단백정량、VDRL、FTA-ABS、RPR、TPPA검측이급RT-PCR검측TP，병분석불동RPR적도조급불동RT-PCR결과조뇌척액이상솔적차이。결과：뇌척액세포혹단백이상자30례（23.26％），VDRL양성2례（1.55％），FTA-ABS양성3례（2.33％），RPR양성5례（3.88％），TPPA양성10례（7.75％），RT-PCR양성32례（24.81％）。2례（1.55％）학진위신경매독。혈청RPR적도≤1∶16조여≥1∶32조환자 CSF 이상솔차이유통계학의의（χ2＝8.37， P ＝0.004）。뇌척액RT-PCR검측양성여음성조뇌척액이상솔차이유통계학의의（χ2＝4.49，P＝0.034）。결론：혈청RPR적도≥1∶32자뇌척액이상솔교고，림상중응인기중시。단순대우미경치료적조기매독이언，용PCR검측뇌척액중TP함량적방법대신경매독적진단불구유명현개치。
To investigate the significance of the cerebrospinal fluid detection for un-treated early syphilis and the diagnostic value for neurosyphilis.Methods:129 cases of cerebrospi-nal fluid ( CSF) in patients with untreated early syphilis were studied.Cell count, protein quanti-tative determination, VDRL, FTA -ABS, RPR, TPPA, and RT -PCR detection for TP were conducted.The abnormal conditions of cerebrospinal fluid in groups of different RPR titer and RT-PCR results were analyzed.Results:Abnormal cells or proteins were detected in cerebrospinal fluid of 30 cases (23.26%) , VDRL positive in 2 cases (1.55%) , FTA-ABS positive in 3 ca-ses (2.33%) , RPR positive in 5 cases (3.88%) , TPPA positive in 10 cases (7.75%) , RT-PCR for TP positive in 32 cases (24.81%) , among them, 2 cases (1.55%) were neurosyphilis. There was a statistical significance in frequency of CSF abnormality between patients with serum RPR titer≤1:16 and≥1:32 (χ2=8.37,P=0.004), as well as between the RT-PCR posi-tive for TP group and RT-PCR negative group (χ2=4.49,P=0.034) .Conclusion:Clinical at-tention should give to those patients with serum RPR titer≥1:32 and a higher frequency of CSF abnormality.TP detected by PCR in CSF is not particular helpful in for neurosyphilis diagnosis in patients with untreated early syphilis.