摘要
目的分析外周血T淋巴细胞亚群异常与神经梅毒认知障碍的相关性。方法选取2013年1月至2023年1月神经梅毒患者150例,根据简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)将患者分成认知障碍组(MMSE<20分或MoCA<26分,n=90)和无认知障碍组(MMSE≥20分和MoCA≥26分,n=60)。比较两组临床资料、血生化指异常情况、T淋巴细胞亚群入院时异常率和治疗后快速(3个月内)转正常率,Logistic回归分析神经梅毒认知障碍相关因素,受试者操作特征曲线(ROC)分析外周血T淋巴细胞亚群诊断神经梅毒认知障碍的价值。结果认知障碍组入院时的CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)以及脑脊液白细胞计数、脑脊液蛋白异常率均高于无认知障碍组,治疗后CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)快速转正常率低于无认知障碍组(P<0.05)。Logistic回归分析显示:CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)异常是神经梅毒出现认知障碍的危险因素(P<0.05)。ROC分析显示,入院时及治疗后CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)诊断神经梅毒认知障碍的AUC分别为0.614、0.647、0.575、0.594,联合诊断的AUC为0.855。结论外周血T淋巴细胞亚群异常与神经梅毒认知障碍显著相关,入院时CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)异常诊断价值较高,可作为临床预测指标。
Objective To analyze the correlation between abnormal T lymphocyte subsets in peripheral blood and cognitive impairment in neurosyphilis.Methods 150 neurosyphilis patients admitted to the neurology department of our hospital from January 2013 to January 2023 were selected and divided into the cognitive impairment group(MMSE<20 or MoCA<26,n=90)and the non-cognitive impairment group(MMSE≥20 and MoCA≥26,n=60)based on the Simplified Mental State Examination(MMSE)and Montreal Cognitive Assessment Scale(MoCA).Compare two sets of clinical data,abnormal blood biochemical indicators,abnormal rate of T lymphocyte subpopulations upon admission,and rapid(within 3 weeks)normalization rate after treatment.Used logistic regression to analyze factors related to cognitive impairment in neurosyphilis,and analyzed the value of peripheral blood T lymphocyte subpopulations in diagnosing cognitive impairment in neurosyphilis using receiver operating characteristic curve(ROC)analysis.Results The CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),cerebrospinal fluid white blood cell count,and cerebrospinal fluid protein abnormality rates at admission in the cognitive impairment group were higher than those in the non-cognitive impairment group.The rapid normalization rates of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)after treatment were lower than those in the non cognitive impairment group(P<0.05).Logistic regression analysis showed that CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)abnormalities were the main factors leading to cognitive impairment in neurosyphilis(P<0.05).ROC analysis showed that the AUC for diagnosing cognitive impairment of neurosyphilis with changes in CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)at admission and after treatment were 0.614,0.647,0.575,and 0.594,respectively,and the AUC for combined diagnosis was 0.855.Conclusion Abnormal T lymphocyte subsets in peripheral blood are significantly associated with cognitive impairment in neurosyphilis,with CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)abnormalities at admission having high diagnostic value and can be use
出处
《浙江临床医学》
2023年第9期1346-1348,共3页
Zhejiang Clinical Medical Journal
关键词
神经梅毒
认知障碍
T淋巴细胞
诊断价值
Neurosyphilis
Cognitive impairment
T lymphocytes
Diagnostic value
