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目的探讨神经梅毒患者的临床表现、实验室检查及影像学特点。方法选择本院2004年3月—2014年3月收治的21例神经梅毒患者资料进行回顾性分析。结果 21例神经梅毒患者中无症状神经梅毒2例,急性缺血性卒中3例,脊髓痨1例,麻痹性痴呆7例,颅内压增高4例,精神行为异常1例,颅神经损伤1例;血清、脑脊液梅毒螺旋体明胶凝集试验(TPPA)阳性21例。本组患者经大剂量青霉素等药物治疗后,17例患者症状有明显好转,1例无效。结论神经梅毒的临床表现多样,容易误诊,梅毒相关抗体的脑脊液及血清检查在疾病的诊断、治疗及判断治疗效果方面至关重要。
Objective To investigate the clinical manifestations, laboratory tests and imaging features of patients with neurosyphilis. Methods The data of 21 cases of neurosyphilis admitted to our hospital from March 2004 to March 2014 were retrospectively analyzed. Results There were 2 cases of asymptomatic neurosyphilis in 21 cases of neurosyphilis, 3 cases of acute ischemic stroke, 1 case of spinal cord gallbladder, 7 cases of paralytic dementia, 4 cases of increased intracranial pressure, 1 case of mental disorder, 1 case of cranial nerve injury Cases; serum, cerebrospinal fluid Treponema pallidum gelatin agglutination test (TPPA) were positive in 21 cases. The group of patients treated with high-dose penicillin and other drugs, the symptoms of 17 patients improved significantly, 1 patient was ineffective. Conclusions The clinical manifestations of neurosyphilis are diverse and easily misdiagnosed. CSF and serum tests of syphilis-related antibodies are crucial in the diagnosis, treatment and diagnosis of the disease.