神经梅毒的临床表现与诊治分析

目的总结分析神经梅毒的临床表现,探讨其诊疗手段的有效性。方法对2003年至2011年我院收治的11例神经梅毒患者进行回顾性分析。结果 11例患者中包括无症状神经梅毒3例,脑脊膜梅毒1例,脑膜血管梅毒4例,麻痹性痴呆3例。11例患者血清TRUST试验及TPPA试验阳性,脑脊液TPPA阳性;9例脑脊液TRUST试验阳性,2例阴性。4例脑膜血管梅毒头颅MRI检查有相应责任病灶,多表现为梗死灶。经抗梅毒等治疗后有症状患者自称症状明显好转。随访6～24个月,除1例患者须行重复治疗外,其余患者无需重复治疗,随访情况良好。结论早期治疗神经梅毒更有利于症状的改善,在临床工作中应加强对神经梅毒的认识,尽可能做到早诊断,早治疗。

Analysis on the Clinical Features of Neurosyphilis and Its Diagnosis and Treatment

Objective To summerize the clinical features of neurosyphilis and explore the effectiveness of diagnosis and treatment.Methods Eleven cases of neurosyphilis in our hospital from 2003 to 2011 were retrospectively analyzed.Results Among the 11 patients,3 cases sufferred from asymptomatic neurosyphilis,l cases of meningeal syphilis,4 cases of meningovascular syphilis,3 cases of paralytic dementia.Toluidine red unheated serum reagin test(TRUST) and Treponema pallidum particle agglutination test(TPPA) of sera were positive in all patients;cerebrospinal fluid(CSF) TRUST was positive in 9 patients.The MRI showed that 4 cases of meningovascular syphilis had corresponding responsibility lesions and most patients presented with infarction.Symptoms improved obviously after treatment.All cases were followed up for 6 to 24 months and all patients were in good condition except that 1 case received repeated treatment.Conclusions Early treatment of neurosyphilis has the advantage of improving symptoms.The understanding of the neurosyphilis,early diagnosis and early treatment are necessary to the clinic.