中枢神经系统螺旋体病诊疗进展.pptxVIP

中枢神经系统螺旋体病诊疗进展-----------脑脊液检查在合并感染HIV的神经梅毒患者诊断中的应用;梅毒;神经梅毒;流行病学;流行病学;神经梅毒的疾病进程;临床症状(梅毒);临床症状(梅毒);临床症状(神经梅毒);临床症状(神经梅毒);临床症状(神经梅毒);临床症状(神经梅毒);临床症状(神经梅毒);临床症状(神经梅毒);临床症状(神经梅毒);影像学检查;Psychiatria Danubina, 2013; Vol. 25, Suppl. 2, pp 153–157;脑脊液检查;? The CSF analysis is abnormal in 70% of NS patients. The main results from CSF general analysis are described in Table 3 :;选择腰穿的标准;神经梅毒的诊断方法存在不足;脑脊液血清性病研究实验室试验（VDRL) 特异性高，但敏感性偏低;CSF细胞数升高，但与HIV感染 所致的细胞数升高难以鉴别;目前神经梅毒的诊断方法均存在不足，而患者体内HIV的状态影响着脑脊液的测定结果;Christina M. Marra University of Washington，Seattle, Washington, USA;Christina M. Marra University of Washington，Seattle, Washington, USA;Christina M. Marra University of Washington，Seattle, Washington, USA;Assessment of %CD19+ Cells ? Specific but not sensitive ? Can augment CSF-VDRL assessment ? Not influenced by ARV use ? Declines after neurosyphilis treatment ? Complex, not readily used or available;Christina M. Marra University of Washington，Seattle, Washington, USA;Point of Care CSF Tests ? Immunochromatographic strip tests (ICTs) – Detect IgG, IgM and IgA antibodies to recombinant treponemal proteins – Intended for use on blood – Sensitive (85-97%) and specific (94-98%) in field trials – Goal is specificity over sensitivity ? RPR/TRUST – Detect IgG and IgM to lipoid material – Not recommended for CSF;ICTs Tested ? Optimized and assessed readability on a test CSF panel – SD Bioline Syphilis 3.0 (Korea) – Syphicheck-WB (India) – Visitect (Scotland);Christina M. Marra University of Washington，Seattle, Washington, USA;Christina M. Marra University of Washington，Seattle, Washington, USA; 四种试剂盒测定梅毒患者的敏感性和特异性;共感染HIV和梅毒的患者;无HIV共感染的梅毒患者;神经梅毒治疗方案;谢谢！