神经梅毒的临床分析.pdfVIP

于中年男性，主要症状以双侧脑皮质、皮质下白质病变及血 管病变可出现各种神经及精神症状，血浆TPHA及RPR阳性， 脑脊液TPHA及RPR基本为阳性，阴性者不能完全排除神经 梅毒诊断，仍需结合临床，提示细胞计数及蛋白升高可支持 诊断。MRI可见散在分布的不完全符合血管分布特征的长T1 长T2异常信号。大剂量青霉素治疗有效，早期治疗预后良 好。 [关键词]神经梅毒；临床特点；疗效 ClinicalfeatureofNeurosyphilis Abstract:Objective Toinvestigatetheclinicalfeatures ofNeurosyphilis.Methods Theclinicaldataof22 Neurosyphilispatientswhotreatmentinourhospitalwere analyzedretrospectively. Results Therewere17malesand 5femalesinthisgroup,agedrangedfrom19-75years.The mainsymptomswerestroke-likeepisodes,decreaseof intelligece,psychiatricsymptom,seizures,headache,weakness oflowerlimbs.Inthecourseofclinicalmanifestationwere decreaseofintelligencein12cases,psychiatricsymptomsin10 cases,seizuresin7cases,somnipathyin6cases,stroke-like episodesin4cases,headachein4cases,weaknessoflower limbsin1case.Thespecificantitreponemalantibodyofblood werepositiveinallpatients.TheCSFcheckin17cases,it showthattreponemapallidumhemagglutinationassay(TPPA) werepositivein16cases,andRapidPlasmaReagin(RPR)were positivein15cases.Leukocytecountsandproteinlevelsin CSFwereincreasedin18cases.Electrocardiogram examinationwascheckedin17cases,itshowedthat9cases wereabnormal,andtherewerewidelyslowwaveinwhole brain.TheMRIwascheckdin20cases,itshowedthat19case wereabnormal,anditmainlyinvolvedinthecortexand subcorticalwhite.AnditshowedhighT1andhighT2. Penicillintreatmentwaseffective.2caseswerereappear,the othercaseshadgoodprognosis.Conclusions Neurophysilis ismainlyseeninthemiddle-agedmen.Mainclinicalsymptoms arebilateralcortexandsubcorticalwhitessymtoms,TPPAand RPRinallcase‘sbloodandmostcasesCSFarepositive,the highofLeukocytecountsandproteinlevelscanprovedthe diagnose.MRIshowedthewidelylesiondontcompletely conformtothevasculardistribution,anditishighT1highT2. Earlypenicillintreatmentwouldbebeetereffective. Keywords:Neurosyphilis;clinicalfeatures;effe