论文部分内容阅读
目的:分析神经梅毒的首发症状及临床特征以提高对其疾病的认识,减少误诊。方法:回顾性分析了43例神经梅毒患者的首发症状、临床表现、实验室检查和影像学特点。结果:43例神经梅毒患者中,首发症状有痴呆(19例)、精神异常(6例)、无症状(6例)、癫痫(5例)、脑梗死(2例)、短暂性脑缺血发作(1例)、脊髓痨(2例)、特殊类型神经梅毒(2例)。43例患者脑脊液检查的TPPA均为阳性,TRUST阳性率为72%。93%患者的脑脊液蛋白轻度升高,57.5%患者的脑脊液细胞数增多。头颅CT和MRI表现无特异性。结论:神经梅毒首发症状表现形式多样,容易误诊,因此有必要加强病史的询问以及血和脑脊液的TPPA检查,以使患者得到早期诊治。
OBJECTIVE: To analyze the initial symptoms and clinical features of neurosyphilis to improve its understanding of the disease and reduce misdiagnosis. Methods: The initial symptoms, clinical manifestations, laboratory tests and imaging features of 43 cases of neurosyphilis were retrospectively analyzed. Results: Of the 43 patients with neurosyphilis, the first symptom was dementia (19 cases), psychosis (6 cases), asymptomatic (6 cases), epilepsy (5 cases), cerebral infarction (2 cases), transient cerebral ischemia Attack (1 case), spinal cord gall (2 cases), special type of neurosyphilis (2 cases). TPPA in CSF was positive in 43 patients, and the positive rate of TRUST was 72%. Cerebrospinal fluid protein was slightly elevated in 93% of patients, and cerebrospinal fluid cells increased in 57.5% of patients. Head CT and MRI showed no specificity. Conclusion: The first symptom of neurosyphilis is diverse and easily misdiagnosed. Therefore, it is necessary to strengthen the inquiry of medical history and the TPPA examination of blood and cerebrospinal fluid in order to make early diagnosis and treatment of patients.