临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
15期
1275-1277
,共3页
神经梅毒%脑脊液%蛋白质含量%预后
神經梅毒%腦脊液%蛋白質含量%預後
신경매독%뇌척액%단백질함량%예후
Neurosyphilis%Cerebrospinal fluid%Protein content%Prognosis
目的：探讨神经梅毒患者脑脊液蛋白质含量与其预后的相关关系。方法以2012年4月至2014年2月62例神经梅毒患者为研究对象，对患者全程进行规范的青霉素去梅治疗。在患者入院时、治疗6个月和2年后，分别测定患者脑脊液压力、白细胞数、蛋白含量，同时对血清和脑脊液进行快速血浆反应素试验（RPR）和梅毒螺旋体明胶颗粒凝集试验（TPPA），并对患者应用精神状态（MMSE）量表和日常生活能力（ADL）量表进行评分。分析病情轻重的相关因素和远期预后的相关指标。结果62例患者中随访得到完整资料的共57例，其中36例患者0.5~1.0年内病情加重，归为加重组；剩余21例患者病情未加重，归为未加重组。两组患者入院时精神状态、生活能力、RPR 和 TPPA 等方面无明显差异（ P ﹥0.05）。两组患者2年 TPPA 均无转阴，加重组脑脊液蛋白含量明显高于未加重组（ P ﹤0.05）。6个月和2年后 MMSE 和 ADL 评分，加重组明显低于未加重组（ P ﹤0.05）。但两组患者6个月和2年后血清 RPR 滴度差异无统计学意义（ P ﹥0.05）。Logistic 回归分析显示，脑脊液蛋白含量与病情加重有关（OR =4.162，P =0.031）。与预后有关因素有：入院时脑脊液蛋白含量（ r =0.821，P ﹤0.01），入院时脑脊液 RPR 滴度（ r =0.292，P =0.027），入院时MMSE 评分（ r =-0.728，P ﹤0.01）。结论神经梅毒患者在治疗过程中前期病情加重的几率较大，但远期效果明显。患者脑脊液蛋白含量与预后有关，蛋白含量越高预后越差。血清 RPR 滴度与预后无关。
目的：探討神經梅毒患者腦脊液蛋白質含量與其預後的相關關繫。方法以2012年4月至2014年2月62例神經梅毒患者為研究對象，對患者全程進行規範的青黴素去梅治療。在患者入院時、治療6箇月和2年後，分彆測定患者腦脊液壓力、白細胞數、蛋白含量，同時對血清和腦脊液進行快速血漿反應素試驗（RPR）和梅毒螺鏇體明膠顆粒凝集試驗（TPPA），併對患者應用精神狀態（MMSE）量錶和日常生活能力（ADL）量錶進行評分。分析病情輕重的相關因素和遠期預後的相關指標。結果62例患者中隨訪得到完整資料的共57例，其中36例患者0.5~1.0年內病情加重，歸為加重組；剩餘21例患者病情未加重，歸為未加重組。兩組患者入院時精神狀態、生活能力、RPR 和 TPPA 等方麵無明顯差異（ P ﹥0.05）。兩組患者2年 TPPA 均無轉陰，加重組腦脊液蛋白含量明顯高于未加重組（ P ﹤0.05）。6箇月和2年後 MMSE 和 ADL 評分，加重組明顯低于未加重組（ P ﹤0.05）。但兩組患者6箇月和2年後血清 RPR 滴度差異無統計學意義（ P ﹥0.05）。Logistic 迴歸分析顯示，腦脊液蛋白含量與病情加重有關（OR =4.162，P =0.031）。與預後有關因素有：入院時腦脊液蛋白含量（ r =0.821，P ﹤0.01），入院時腦脊液 RPR 滴度（ r =0.292，P =0.027），入院時MMSE 評分（ r =-0.728，P ﹤0.01）。結論神經梅毒患者在治療過程中前期病情加重的幾率較大，但遠期效果明顯。患者腦脊液蛋白含量與預後有關，蛋白含量越高預後越差。血清 RPR 滴度與預後無關。
목적：탐토신경매독환자뇌척액단백질함량여기예후적상관관계。방법이2012년4월지2014년2월62례신경매독환자위연구대상，대환자전정진행규범적청매소거매치료。재환자입원시、치료6개월화2년후，분별측정환자뇌척액압력、백세포수、단백함량，동시대혈청화뇌척액진행쾌속혈장반응소시험（RPR）화매독라선체명효과립응집시험（TPPA），병대환자응용정신상태（MMSE）량표화일상생활능력（ADL）량표진행평분。분석병정경중적상관인소화원기예후적상관지표。결과62례환자중수방득도완정자료적공57례，기중36례환자0.5~1.0년내병정가중，귀위가중조；잉여21례환자병정미가중，귀위미가중조。량조환자입원시정신상태、생활능력、RPR 화 TPPA 등방면무명현차이（ P ﹥0.05）。량조환자2년 TPPA 균무전음，가중조뇌척액단백함량명현고우미가중조（ P ﹤0.05）。6개월화2년후 MMSE 화 ADL 평분，가중조명현저우미가중조（ P ﹤0.05）。단량조환자6개월화2년후혈청 RPR 적도차이무통계학의의（ P ﹥0.05）。Logistic 회귀분석현시，뇌척액단백함량여병정가중유관（OR =4.162，P =0.031）。여예후유관인소유：입원시뇌척액단백함량（ r =0.821，P ﹤0.01），입원시뇌척액 RPR 적도（ r =0.292，P =0.027），입원시MMSE 평분（ r =-0.728，P ﹤0.01）。결론신경매독환자재치료과정중전기병정가중적궤솔교대，단원기효과명현。환자뇌척액단백함량여예후유관，단백함량월고예후월차。혈청 RPR 적도여예후무관。
Objective To investigate the relationship between cerebrospinal fluid( CSF)changes and prognosis in patients with neu-rosyphilis. Methods 62 patients admitted to our hospital from April 2012 to February 2014 and treated with penicillin standardly during the whole course. Rapid plasma regain test(RPR)and treponema pallidum gelatin particle agglutination test(TPPA)were performed in the serum and cere-brospinal fluid of all the patients. The mini - mental state examination(MMSE)and activity of daily living(ADL)scale were scored at admis-sion. We investigated the relationship between CSF changes and prognosis in patients with neurosyphilis. Results 57 cases have complete data. All these patients were divided into two groups. 36 patients were in disease - worsened group and 21 in disease - not - worsened group. No signifi-cant difference between the two groups in mental state,life skills,RPR and TPPA( P ﹥ 0. 05). No patients of 2 years'TPPA became negative, and the cerebrospinal fluid of patients in the disease - worsened group was significantly higher than that of patients in disease - not - worsened group( P ﹤ 0. 05). The scores of MMSE and ADL scores were significantly lower than those of patients in disease - not - worsened group at 6 month and 2 year after treatment( P ﹤ 0. 05). But there was no statistical significance in serum RPR( P ﹥ 0. 05). Logistic regression analysis showed that the cerebrospinal fluid protein was related to the worse disease(OR = 4. 162,P = 0. 031). Factors associated with prognosis:cere-brospinal fluid protein content( r = 0. 821,P ﹤ 0. 01),cerebrospinal fluid RPR titer( r = 0. 292,P = 0. 027),MMSE score( r = - 0. 728, P ﹤ 0. 01). Conclusion Most patients are worsen early,but the long term effect is obvious. Close relation between cerebrospinal fluid protein content and prognosis is noted;the higher the cerebrospinal fluid protein content. No relation between serum RPR titer and both severity of illness.
