【摘要】 目的　探讨神经梅毒的误诊原因 ,提高诊断率。方法　回顾性分析 10例首诊漏诊或误诊的神经梅毒患者的临床资料及误诊情况。结果　 5例以脊髓症状起病 ,被误诊为颈椎病、脊髓炎、脊髓压迫症、脊髓神经根炎 ;4例以偏瘫、偏侧感觉障碍起病 ,被误诊为脑卒中 ;1例以视神经症状起病 ,被误诊为玻璃体浑浊、视乳头水肿。误诊原因为 :1对近年神经梅毒的发病率上升认识不足 ;2对病史的完整及真实性重视不够 ;3对神经梅毒复杂的临床表现不熟悉 ,体检不够全面 ;4仅仅满足于症状学的诊断 ,未能深入探索病因学诊断。结论　神经梅毒临床表现较为复杂 ,对可疑病例应注重相关病史 ,认真全面体检 ,进行特异性血清学检查以提高诊断率。更多还原

【Abstract】 Objective To investigate the misdiagnostic cause of neurosyphilis and to improve the diagnostic level.Method The clinical data of 10 cases with neurosyphilis misdiagnosed at initial reception were analyzed retrospectively.Result Among 10 cases, 5 were characteristic by spinal cord disorder and misdiagnosed as cevial spondylosis, myelitis, compressive myelopathy or spinal radiculitis;4 by hemiplegia and were misdiagnosed as stroke, and 1 by optic nerve syndrome and were misdiagnosed as vitreum turbid, papilledema. The main causes leading to misdiagnosis included:① Lack of awareness of increased neurosyphilis morbidity in recent years; ② Neglect of the integrity and validity of history; ③Being unfamiliar with the complicated clinical manifestation;④ Being content with symptom diagnosis and unable to explore the etiology.Conclusion The diversity of clinical manifestation was characteristics of neurosyphilis. The highly suspected case should be screened for history, symptom, sign and laboratory findings, especially syphilis specific serology to improve diagnosis level.更多还原