神经梅毒的临床表现与诊断的探讨

目的探讨神经梅毒的诊断相关问题及各种检查的诊断价值。方法回顾性分析我院2000~2004年收治的19例神经梅毒患者的临床资料。结果脊髓痨2例,间质型神经梅毒4例,麻痹性痴呆13例;脑脊液梅毒螺旋体抗原凝集试验(CSF-TPPA)100%阳性,脑脊液快速血浆反应素试验(CSF-RPR)阳性率84.21%,脑脊液检查蛋白增高阳性率68.42%,细胞数增高阳性率78.94%;头颅CT和MRI表现脑萎缩、梗塞或脱髓鞘病变等改变。结论神经梅毒的诊断应结合临床表现,实验室、影像学、电生理等检查综合分析。

The clinical manifestations and diagnostic problems of neurosyphilis

Objective: To analyze the problems in diagnosis of neurosyphilis and the dignositic values of different examinations. Methods: The clinical data on nineteen patients with neurosyphilis diagnosed and treated in our hospital during the period of 2000-2004 were analyzed retrospectively. Results: Two patients were myelophthisis, four mesenchymal neurosyphilis and paralytic dementia 13. All these patients had positive treponema pallidum particle assay (TPPA) and 84.21% of the patients positive rapid plasma reagin test (RPR)of the cerebrospinal fluid. The cerebrospinal fluid protein increased in 68.72% of the patients, and cells increased in 78.94% of the patients. Changes of cerebral atrophy, infarction, and demyelination were found on the CT and MRI of cranium. Conclusion : The diagnosis of neurosyphilis should be made according to the combination of clinical manifestations, laboratory tests, and imageological and electrophysiological evidences.