76例首诊精神科的神经梅毒患者治疗和转归

目的 了解神经梅毒患者就诊于精神科的现状,探讨该人群的转归及预后.方法 选择2008年1月~2015年12月在我院门诊就诊、RPR筛查结果阳性、经确诊为神经梅毒的精神疾病患者.在确诊后3,6,12个月进行随访.结果 纳入随访的76例患者中,男性43例,女性33例.随访至12个月时,36例出现不同程度的认知功能下降;18例为躁狂或抑郁状态;10例出现幻觉及妄想状态;9例好转,2例临床治愈,1例死亡.76例患者均使用抗精神病、抗抑郁、抗躁狂或抗焦虑药物治疗.32例患者进行驱梅治疗,44例未用驱梅药物治疗,将随访患者分为驱梅治疗组与未驱梅治疗组,两组患者的MMSE评分差异无统计学意义(P>0.05);两组患者的MMSE评分于随访12个月与基线比较差异均有统计学意义(P<0.05).结论 抗精神病药物和驱梅治疗对神经梅毒患者的疗效并不显著,神经梅毒患者存在认知功能下降.

Treatment and outcome of 76 neurosyphilis patients first-visiting in psychiatric clinic

Objective To investigate the current situation of neurosyphilis patients first-visiting in psychiatric clinic,and explore the outcome and prognosis of these patients. Methods Outpatients who had the positive result of RPR and were diagnosed as neurosyphilis were selected from January 2008 to Decem-ber 2015. All patients were followed up in 3 months,6 months and 12 months. Results In these 76 patients, 43 were male,33 were female. Up to 12 months follow-up survey,36 patients showed cognitive impairment, 18 showed manic or depressive states,10 had hallucinations and delusions,9 showed improvement,2 were cured and one died. All 76 patients were treated with anti-psychotic drugs,antidepressants,antimanics or an-ti-anxiety drugs. 32 patients received anti-syphilis treatment,while 44 patients were not. So all patients were divided into anti-syphilis treatment group and non-anti-syphilis treatment group. MMSE scores of patients in two groups were not significantly different (P>0.05). MMSE scores of patients in either group were significantly dif-ferent in 12 months follow-up survey with that at baseline (P<0.05). Conclusions The effect of antipsychotics treatment and anti-syphilis treatment for neurosyphilis patients are not significant. Neurosyphilis patients have cognitive impairment.