【摘要】 目的了解HIV抗体阴性的神经梅毒临床表现及实验室检查特征。方法回顾分析2007年1月-2016年6月本院诊治的HIV抗体阴性的神经梅毒患者的临床资料。结果 28例患者中男17例,女11例;年龄24~69岁,平均(54.32±9.36)岁。无症状神经梅毒2例、脑膜血管梅毒1例、麻痹性痴呆20例(其中2例合并脑膜血管梅毒、1例合并脊髓痨)、脊髓痨3例、眼损害2例。表现为智力减退15例、精神行为异常18例。23例血清TRUST滴度≥1∶16;28例脑脊液(CSF)VDRL均阳性,20例麻痹性痴呆患者中,CSF白细胞升高16例,蛋白升高17例;6例神经梅毒患者治疗后CSF白细胞/蛋白较治疗前下降者有4例,但该4例临床症状无改善。结论神经梅毒可主要表现为智力减退、精神行为异常,梅毒血清学检查阳性尤其是血清TRUST高滴度是诊断线索,要进一步检查CSF-VDRL及CSF常规确诊。更多还原

【Abstract】 Objective To gain the knowledge of the clinical manifestation and laboratory features of HIV negative neurosyphilis. Methods A retrospective analysis of the clinical data of 28 cases of HIV negative neurosyphilis from January 2007 to June 2016 in our hospital. Results Seventeen of 28 cases were males and 11 cases were females,and the age was between 24 to 69 years( mean 54. 3 ± 9. 36). There were 2 cases of asymptomatic neurosyphilis,1 case of meningovascular syphilis,and 20 cases of paralysis of dementia( of those 1 case with spinal tuberculosis and 2 patients with myelophthisis and meningovascular syphilis),3 cases of myelophthisis,and 2 cases with eye damage. The main manifestations of mental decline in 15 cases,mental and behavioral abnormalities in 18 cases. The titer of TRUST of 23 cases was≥1 ∶ 16,the CSF-VDRL of all cases were positive,cerebrospinal fluid leukocyte elevation in 16 cases of 20 paralysis of dementia,of whom 17 cases with increased cerebrospinal fluid protein. The CSF white blood cell/protein decreased in 6 neurosyphilis patients after treatment,but the clinical symptoms were not improved in 4 cases. Conclusion The patients of neurosyphilis can mainly manifest as hypophrenia and mental and behavioral disorders. Positive serological tests for syphilis, especially high serum TRUST titers,further examination of CSF-VDRL and CSF is required for diagnosis.更多还原