43例HIV合并梅毒感染临床及脑脊液分析

目的：分析HIV合并梅毒的临床表现及实验室特征。方法：回顾性分析2014年3月至2017年7月在我院皮肤科进行腰穿的HIV合并梅毒感染的43例患者的人口学特点、临床表现及实验室检查。结果：43例患者中男39例，女4例，中位年龄为31.5岁。有3例（7.0%）符合神经梅毒诊断（脑脊液表现为白细胞≥20/μL并伴有脑脊液RPR阳性）。这3例患者均为二期梅毒，临床表现均为眼部症状，CD4均＜350个/μL，血清RPR均≥1:32。结论：在HIV合并梅毒感染时，神经梅毒尤其好发于血清RPR≥1:32，CD4＜350个/μL的二期梅毒患者。

Analysis of 43 cases with HIV accompanied with syphilis

Objective：To analyze the characteristics of clinical manifestations and laboratory testing in patients with HIV accompanied with syphilis. Method：The demographic characteristics, clinical manifestations and laboratory testing in 43 patients with HIV accompanied with syphilis who were performed lumbar puncture in our department from March 2014 to July 2017 were analyzed retrospectively. Results：Of 43 patients, 39 were male and 4 were female, with an median age of 31.5 years old. Three cases (7.0%) were in accordance with the diagnosis of neurosyphilis with the white blood cells≥20/uL and positive RPR in the cerebrospinal fluid. Three cases with neurosyphilis were all secondary syphilis. The clinical manifestation of them showed ocular symptoms and the laboratory testing showed CD4<350/μL and serum RPR ≥1:32. Conclusion：In the patients with HIV accompanied with syphilis， neurosyphilis often occur in secondary syphilis patients whose serum RPR ≥ 1:32 and CD4 <350 /μL .