以缺血性脑卒中为主要症状的HIV阴性神经梅毒患者的临床分析

目的研究以缺血性脑卒中为主要症状的HIV阴性神经梅毒患者的临床特点,提高对该病的认识,减少临床误诊。方法回顾性分析98例神经梅毒患者。对照组包括16名非神经梅毒缺血性脑卒中患者。分析缺血性脑卒中作为不同类型神经梅毒的主要症状,神经梅毒缺血性脑卒中误诊率的比例,以及与相关危险因素的关系。结果 98例神经梅毒患者中,12例发生缺血性脑卒中为主要症状,其中1例为脑膜炎型神经梅毒,11例为脑膜血管型神经梅毒。神经梅毒缺血性脑卒中患者中只有2名有卒中史,其它10例均在随访治疗期间被诊断为神经梅毒,误诊率高达83.33%。此外,除高血压外,两组间心血管危险因素无显著差异(P>0.05)。结论在临床实践中,特别是在紧急情况下,任何缺血性脑卒中患者都应进行神经梅毒筛查。

Clinical analysis of HIV-negative neurosyphilis patients with ischemic stroke as main symptom

Objective To study the clinical features of HIV-negative neurosyphilis patients with ischemic stroke as the main symptom,to improve the understanding of the disease and reduce clinical misdiagnosis.Methods This article retrospectively analyzed the clinical data of 98 patients with neurosyphilis.The control group included 16 patients with non-neuro-syphilis ischemic stroke.Taking ischemic stroke as the main symptoms of different types of neurosyphilis,the proportion of misdiagnosis rate of neurosyphilis ischemic stroke,and the relationship with related risk factors were analyzed.Results Of the 98 patients with neurosyphilis,12 had ischemic stroke as the main symptom,including a case of meningitis-type neurosyphilis and 11 cases of meningeal vascular syphilis.Only 2 of the patients with neurosyphilis ischemic stroke had a history of stroke,and the other 10 cases were diagnosed with neurosyphilis during follow-up treatment,the rate of misdiagnosis as high as 83.33%.Conclusions In clinical work,especially in emergencies,each patient with ischemic stroke should be screened for neurosyphilis.