神经梅毒患者血清治疗有效的影响因素分析

 目的探索神经梅毒患者治疗后发生血清治疗有效的影响因素。方法纳入2011年1月至2018年12月厦门大学附属中山医院的神经梅毒住院患者，比较不同年龄、性别、神经梅毒分型、血清RPR滴度、血清TPPA滴度、脑脊液RPR滴度、脑脊液TPPA滴度、白细胞计数、总蛋白含量、病程、治疗方案、疗程数、既往治疗史、冶游史、颅内感染史、脑梗死史的患者治疗后发生血清治疗有效的概率。结果共纳入120例患者。血清RPR滴度≥1 ∶ 16、脑脊液RPR滴度≥1 ∶ 4的患者血清治疗有效的概率更高（均P<0.05)；病程≥1年、接受≥3个疗程、陈旧性脑梗死的患者血清治疗有效的概率更低（均P<0.05）。结论神经梅毒患者治疗后发生血清治疗有效的不利因素包括病程长、治疗次数多、既往脑梗死，应及时关注此类神经梅毒患者，尽早干预，避免贻误治疗。

Influence factors of serological response in neurosyphilis after the treatment

ObjectiveTo investigate factors influencing serological response in neurosyphilis after the treatment. MethodsThe odds of serological response in neurosyphilis after the treatment were compared among different age, sex, type of neurosyphilis, baseline serum RPR titer, serum TPPA titer, CSF RPR titer, CSF TPPA titer, CSF leukocyte counts, CSF proteins, disease duration, drugs, course of treatment, history of treatment, unsafe sexual behavior, intracranial infection and cerebral infarction. ResultsThe odds of serological response in neurosyphilis after the treatment were higher in patients with serum RPR titer ≥1∶ 16 and CSF RPR titer ≥1∶ 4. The odds of serological response were lower in patients with disease duration ≥1 year, courses of treatment ≥3, and a history of cerebral infarction (P<0.05). ConclusionsThe negative factors influencing serological response in neurosyphilis after the treatment include longer disease duration, more numbers of treatment, and a history of cerebral infarction. Timely attention should be paid to these patients with neurosyphilis. Intervention should be given as early as possible to avoid delay in the treatment.