中华实验和临床感染病杂志（电子版）
中華實驗和臨床感染病雜誌（電子版）
중화실험화림상감염병잡지（전자판）
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2014年
5期
654-657
,共4页
神经梅毒%甲苯胺红不加热血清反应素试验%脑脊液%诊断
神經梅毒%甲苯胺紅不加熱血清反應素試驗%腦脊液%診斷
신경매독%갑분알홍불가열혈청반응소시험%뇌척액%진단
Neurosyphilis%Toluidine red unheated serum test%Cerebrospinal lfuid%Diagnosis
目的：分析神经梅毒诊断的临床及实验室相关因素。方法收集首都医科大学附属北京地坛医院2008至2013年住院的153例梅毒患者的临床和实验室资料，分为非神经梅毒组（85例）和神经梅毒组（68例）；比较两组患者性别、年龄、神经系统症状、血清甲苯胺红不加热血清反应素试验（TRUST）滴度、脑脊液梅毒螺旋体明胶颗粒凝集试验（TPPA）、脑脊液TRUST滴度、脑脊液压力、脑脊液细胞数和脑脊液蛋白水平的差异，分析神经梅毒诊断的相关因素。结果神经梅毒组与非神经梅毒组患者年龄、血清TRUST、脑脊液TRUST、脑脊液白细胞和脑脊液蛋白等差异具有统计学意义（P均＜0.05）；而脑脊液压力差异无统计学意义（P=0.383）。神经梅毒组的脑脊液TRUST滴度与血清TRUST滴度、脑脊液蛋白定量呈正相关关系（r=0.254、0.399，P=0.036、0.002）。将年龄、血清TRUST、脑脊液TPPA、脑脊液TRUST、脑脊液白细胞以及脑脊液蛋白等变量进行Logistics回归分析发现，脑脊液TPPA阳性、脑脊液蛋白升高和神经梅毒的诊断相关，且差异具有统计学意义（OR=9.955、27.707；95%CI：1.127～87.960、1.939～396.010，P=0.039、0.014）。结论神经梅毒脑脊液TRUST滴度与血清TRUST滴度、脑脊液蛋白呈正相关；除脑脊液TRUST阳性外，脑脊液TPPA阳性以及脑脊液蛋白异常（≥50 mg/dl）对于神经梅毒的诊断意义较大。
目的：分析神經梅毒診斷的臨床及實驗室相關因素。方法收集首都醫科大學附屬北京地罈醫院2008至2013年住院的153例梅毒患者的臨床和實驗室資料，分為非神經梅毒組（85例）和神經梅毒組（68例）；比較兩組患者性彆、年齡、神經繫統癥狀、血清甲苯胺紅不加熱血清反應素試驗（TRUST）滴度、腦脊液梅毒螺鏇體明膠顆粒凝集試驗（TPPA）、腦脊液TRUST滴度、腦脊液壓力、腦脊液細胞數和腦脊液蛋白水平的差異，分析神經梅毒診斷的相關因素。結果神經梅毒組與非神經梅毒組患者年齡、血清TRUST、腦脊液TRUST、腦脊液白細胞和腦脊液蛋白等差異具有統計學意義（P均＜0.05）；而腦脊液壓力差異無統計學意義（P=0.383）。神經梅毒組的腦脊液TRUST滴度與血清TRUST滴度、腦脊液蛋白定量呈正相關關繫（r=0.254、0.399，P=0.036、0.002）。將年齡、血清TRUST、腦脊液TPPA、腦脊液TRUST、腦脊液白細胞以及腦脊液蛋白等變量進行Logistics迴歸分析髮現，腦脊液TPPA暘性、腦脊液蛋白升高和神經梅毒的診斷相關，且差異具有統計學意義（OR=9.955、27.707；95%CI：1.127～87.960、1.939～396.010，P=0.039、0.014）。結論神經梅毒腦脊液TRUST滴度與血清TRUST滴度、腦脊液蛋白呈正相關；除腦脊液TRUST暘性外，腦脊液TPPA暘性以及腦脊液蛋白異常（≥50 mg/dl）對于神經梅毒的診斷意義較大。
목적：분석신경매독진단적림상급실험실상관인소。방법수집수도의과대학부속북경지단의원2008지2013년주원적153례매독환자적림상화실험실자료，분위비신경매독조（85례）화신경매독조（68례）；비교량조환자성별、년령、신경계통증상、혈청갑분알홍불가열혈청반응소시험（TRUST）적도、뇌척액매독라선체명효과립응집시험（TPPA）、뇌척액TRUST적도、뇌척액압력、뇌척액세포수화뇌척액단백수평적차이，분석신경매독진단적상관인소。결과신경매독조여비신경매독조환자년령、혈청TRUST、뇌척액TRUST、뇌척액백세포화뇌척액단백등차이구유통계학의의（P균＜0.05）；이뇌척액압력차이무통계학의의（P=0.383）。신경매독조적뇌척액TRUST적도여혈청TRUST적도、뇌척액단백정량정정상관관계（r=0.254、0.399，P=0.036、0.002）。장년령、혈청TRUST、뇌척액TPPA、뇌척액TRUST、뇌척액백세포이급뇌척액단백등변량진행Logistics회귀분석발현，뇌척액TPPA양성、뇌척액단백승고화신경매독적진단상관，차차이구유통계학의의（OR=9.955、27.707；95%CI：1.127～87.960、1.939～396.010，P=0.039、0.014）。결론신경매독뇌척액TRUST적도여혈청TRUST적도、뇌척액단백정정상관；제뇌척액TRUST양성외，뇌척액TPPA양성이급뇌척액단백이상（≥50 mg/dl）대우신경매독적진단의의교대。
Objective To analyze the dignose related elements of neurosyphilis in the clinical and laboratory. Methods Clinical and laboratory datas of 153 hospitalized patients with syphilis were collected in Beijing Ditan Hospital, Capital Medical Unversity during 2008-2013, which divided into non neurosyphilis group (85 cases) and neurosyphilis group (68 cases). The two groups compared the differences in sex, age, neurological symptoms, serum tolulized red unheated serum test (serum TRUST), cerebrospinal lfuid (CSF) titer of treponemal pallidum particle agglutination (TPPA), CSF titer of TRUST, CSF pressure, CSF-white blood cell counts and CSF protein, respectively. The related factors in the diagnosis of neurosyphilis were analyzed. Results The age, serum titer of TRUST, CSF titer of TRUST, CSF-white blood cell counts and CSF protein of non neurosyphilis patients and the neurosyphilis patients were compared with signiifcant differences (all P<0.05);but the CSF pressure was with no signiifcant difference (P=0.383). In neurosyphilis group, there were positive correlations between CSF titer of TRUST and the titer of serum TRUST titer, CSF protein (r=0.254, 0.399;P=0.036, 0.0022). The CSF TPPA positive and the increasing of CSF protein levels were found associated with the diagnosis of neurosyphilis, by Logistic regression analysis in age, serum titer of TRUST, CSF TPPA, CSF titer of TRUST, CSF-white blood cell counts and CSF protein, with signiifcance difference (OR=9.955, 27.707;95%CI:1.127-87.960, 1.939-396.010, P=0.039, 0.014). Conclusions The CSF titer of TRUST in neurosyphilis was positively correlated with serum titer of TRUST, CSF protein. Excepting for the facor of CSF TRUST positive, the CSF TPPA positive and CSF protein abnormal (≥50 mg/dl) had signiifcance for the diagnosis of neurosyphilis.
