摘要
目的:探讨神经梅毒患者的临床表现、诊断和治疗。方法:回顾性分析7例神经梅毒患者的临床症状、体征,磁共振特点,血清、脑脊液变化及治疗。结果:7例患者中,脑膜血管型梅毒4例,脊髓痨1例,麻痹性痴呆1例,脑膜梅毒1例。头颅MRI异常6例,脊髓MRI异常1例,但无明显特异性。治疗后脑脊液蛋白、细胞数下降,血清及脑脊液TPPA无明显下降,血清及脑脊液RPR有不同程度下降。经青霉素或头孢曲松治疗,6例有效,1例出院2个月后复发。7例均未发生吉-海反应。结论:神经梅毒临床表现多种多样,临床极易误诊,脑脊液检查是关键。
Aim： To study the manifestation, diagonosis and therapy in the neurosyphilis patients. Methods： 7 patients with neurosyphilis were analyzed includind the clinical manifestation, abnormality of MRI, serum and CSF, therapy response, etc. Results： Among the 7 cases there are 4 cases of meningovascular syphilis, 1 case of general paresis, 1 case of meningeal syphilis, 1 case of tabes dorsalis. Abnormal signals were demonstrated in head MRI of 6 cases and in spinal MRI of lcase. The cell count, total protein of CSF, titer of RPR in serum and CSF were decreased after therapy with antibiotics（penicillin or ceftriaxone） and no Jarisch-Herxheimer reaction was found all of the cases. 6 cases were effective, 1 case was recurred after the treatment. Conclusion： The clinical manifestation of neurosyphilis were complex and varied. It is easy to result in a fault diagnosis in clinical work. TPPA, RPR test and examination of the CSF were necessary to diagonosis of neurosyphilis.
出处
《中国临床神经科学》
2006年第6期633-637,共5页
Chinese Journal of Clinical Neurosciences
关键词
神经梅毒
临床分析
脑脊液
neurosyphilis
manifestation
cerebrospinal fluid
