神经梅毒的临床特征分析和诊断(附6例报道).pdfVIP

Med 31，No．10 ShanghaiJ，2008。Vol ·论著· 神经梅毒的临床特征分析及诊断(附6例报道) 王中魁赵玫张社卿 丁素菊 【摘要】 目的分析神经梅毒的临床特征，做到早期诊断和治疗。方法 回顾性分析经实验室检查确诊 的6例神经梅毒患者的有关临床资料。结果 6例患者中。间质型梅毒3例，实质型梅毒3例，其中1例为脊髓 痨，2例为麻痹性痴呆。6例患者的血、脑脊液梅毒抗体均为阳性。脑脊液蛋白含量增高或正常。细胞数增多，以 单核细胞为主。神经梅毒的磁共振成像检查表现复杂多样，无特异性；间质型梅毒的影像表现为脑梗死、软脑 膜增强等；麻痹性痴呆表现为脑萎缩、双侧颢叶及海马区异常信号。青霉素治疗能明显改善临床症状及预后。 结论神经梅毒的临床表现多样．易误诊，临床表现和血清、脑脊液梅毒抗体阳性是确诊的依据。 【关键词】神经梅毒；临床表现；诊断 ofclinicalfeaturesand of of6a嗍WANG Analysis diagnosisneurosyphilis：areport Zhongkui．ZHA0Mei。 ZHANG of Medical Sheqing，DINGSuj“．DepartmentNeurology，ChanghaiHospital，SecondMilitary 200433，China University，Shanghai author：DING Corresponding S巧材 To theclinicalfeaturesof asto the [Abstract]0bjectiveanalyze neurosyphilis，aohelp earlydiagnosis andtreatment．MethodsTheclinicaldataof6 withconfirmed were aria— patients neurosyphilisretrospectively The6casesincluded3interstitial and3substantial 1 lyzed．Results neurosyphilis neurosyphilis，withhaving tabesdorsalisand2 ofinsane(GPI)．Patientswereall of reac— having paralysis positivesyphilisantibody general tioninserumand contentwasincreasedornorrnalandceilsincreased， cerebrospinalfluid(CSF)；CSFprotein of were mainly complex，varied，andnonspecific．Interstitialneurosyphi- monocytes．MRIfindingsneurosyphilis lishadan ofcerebralinfarctionandenhancedsoft hadamanifestationofbrain image meninges；gene