摘要
目的分析HIV/AIDS合并神经梅毒患者的临床特征,为HIV/AIDS合并神经梅毒(NS)的诊治工作提供参考。方法本研究对2017年1月—2021年12月重庆市公共卫生医疗救治中心收治的HIV/AIDS合并神经梅毒人群的临床资料进行回顾性分析,按照是否合并神经系统症状和体征进行分组,比较有症状组和无症状组的年龄、性别、感染途径、是否接受高效抗逆转录病毒治疗(highly active anti-retroviral therapy,HAART)、CD4、HIV RNA、血清梅毒RPR滴度、脑脊液检查及其临床转归等是否存在差异。结果本研究共纳入86例HIV合并神经梅毒患者,有症状组70例,无症状组16例,平均年龄(37.63±1.36)岁,男84例(97.67%)。42例(48.84%)患者已接受HAART,54例(62.79%)CD4<200个/μL,60例(69.77%)HIV RNA>1000 CPs/mL,感染途径以同性性行为感染为主(56.98%)。两组在年龄、同性性行为、异性性行为差异有统计学意义(P<0.05)。两组脑脊液总蛋白、脑脊液HIV RNA差异有统计学意义(P<0.05),但在患者脑脊液压力、白细胞计数、脑脊液RPR阳性差异均无统计学意义(P>0.05)。两组在脑脊液总蛋白下降(P=0.019)、头颅CT/MRI改善(P=0.036)差异有统计学意义;但在脑脊液白细胞计数下降(P=0.58)、脑脊液RPR滴度下降(P=1.000)、血RPR下降(P=0.348)方面差异无统计学意义。有症状组有2例脑膜血管型患者死亡,其余患者均好转出院。有症状组住院时间(20.57±4.65)d,长于无症状组(17.25±2.24)d,差异有统计学意义(P<0.05)。结论HIV/TP合并感染,高的血清RPR滴度可能是合并NS的预测因子,建议尽早行腰椎穿刺术排查。无症状组年龄更小,有症状组脑脊液蛋白、脑脊液HIV RNA载量更高。
Objective To analyze the clinical characteristics of HIV/AIDS patients with neurosyphilis,and to provide reference for the diagnosis and treatment of HIV/AIDS patients with neurosyphilis.Methods In this study,the clinical data of HIV/AIDS patients with neurosyphilis admitted to Chongqing Public Health Medical Treatment Center from January 2017 to December 2021 were retrospectively analyzed.The patients were divided into groups according to whether they had neurological symptoms and signs.There were no differences in age,sex,route of infection,highly active anti-HAART(HAART),CD4,HIV RNA,serum syphilis RPR titer,cerebrospinal fluid test and clinical outcome between symptomatic and asymptomatic groups.Results A total of 86 patients with HIV complicated with neurosyphilis were enrolled in this study,including 70 patients in the symptomatic group and 16 patients in the asymptomatic group.The average age was(37.63±1.36)years,and 84 patients were male,accounting for 97.67%.Forty-two cases(48.84%)had received HAART,54 cases(62.79%)had CD4<200 cells/μL,and 60 cases(69.77%)had HIV RNA>1000 CPs/mL.The main route of infection was homosexual sex(56.98%).There were significant differences in age,homosexual behavior and heterosexual behavior between the two groups(P<0.05).There were significant differences in CSF total protein and CSF HIV RNA between the two groups(P<0.05),but there were no significant differences in CSF pressure,white blood cell count and CSF RPR positive(P>0.05).There were significant differences in the decrease of total protein in cerebrospinal fluid(P=0.019)and the improvement of head CT/MRI(P=0.036)between the two groups.However,there was no significant difference in the decrease of cerebrospinal fluid white blood cell count(P=0.58),cerebrospinal fluid RPR titer(P=1.000),and blood RPR(P=0.348)between the two groups.There were significant differences in the decrease of total protein in cerebrospinal fluid(P=0.019)and the improvement of head CT/MRI(P=0.036)between the two groups.However,there was no signif
作者
张维
李奇穗
邓长刚
黄薇
孙艳雨
袁婧
ZHANG Wei;LI Qisui;DENG Changgang;HUANG Wei;SUN Yanyu;YUAN Jing(Chongqing Public Health Medical Center,Infectious Disease Department,Chongqing 400036,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2023年第5期576-580,共5页
The Chinese Journal of Dermatovenereology
基金
重庆市科卫中医药技术创新与应用发展项目(2020ZY4094)
重庆市科卫中医药技术创新与应用发展项目(2021ZY4265)。
关键词
艾滋病病毒
神经梅毒
临床症状
临床特征
HIV/AIDS
Neurosyphilis
Clinical symptoms
Clinical characteristics
