梅毒血清固定患者126例临床及脑脊液检测分析

摘要

Objective To explore the positive rate of laboratory examination of cerebrospinal fluid in patients with syphilis confirmed by serum detection. Methods Clinical data of 408 patients with sero - positive results of syphilis in this hospital during June 2011 to May 2015 were analyzed,the samples of cerebral spinal fluid in 126 cases of them were examined(experimental group). Other 46 syphilis clinically cured pa-tients(control group)were selected for laboratory examination of cerebrospinal fluid. Results Among 1 506 cases with syphilis,sero fixation of syphilis had been seen in 408 cases,and the incidence of sero - positive rate was 27. 09% . The samples of cerebral spinal fluid of 126 cases were examined,result of positive TPPA was 22. 22%(28 / 126 cases);and the positive rate of RPR was15. 87%(20 / 126 cases);the percentage of abnormal white blood cell count( > 10 × 106 / L)was 19. 05%(24 / 126 cases);protein > 500 mg / L had been seen in 21 / 126 cases(16. 67% ). The data of these four groups were significantly higher than those of control group( P < 0. 05). 24 patients in experimental group were di-agnosed as asymptomatic neurosyphilis,accounted for 19. 05% . Conclusion The positive rate of CSFexamination in patients with positive syphi-lis sero fixation is higher,in order to reduce misdiagnosis and missed diagnosis of neurosyohilis,laboratory examination of cerebral spinal fluid must be applied as a routine clinical examination for patients with sero - fast syphilis.%目的：探讨梅毒血清固定患者脑脊液实验室检查结果的阳性率。方法对2011年6月至2015年5月唐山市传染病医院性艾科收治的梅毒血清固定的408例患者进行临床分析，其中126例行腰穿脑脊液实验室检查（实验组）。另选取46例梅毒临床治愈患者（对照组）行脑脊液实验室检查。结果1506例梅毒患者，梅毒血清固定的发生率为27.09%，其中126例经脑脊液检查，检查结果梅毒螺旋体特异性抗体明胶凝集试验（ TPPA）阳性（28/126）例（22.22%）；非特异性梅毒快速血浆反应素环状卡实验（RPR）阳性（20/126）例（15.87%）；白细数胞异常（＞10×106/ L）（24/126）例（19.05%）；蛋白（＞500 mg/ L）（21/126）例（16.67%）。四组数据均显著高于对照组（ P ＜0.05）。实验组确诊为无症状神经梅毒24例，占19.05%。结论梅毒血清固定患者脑脊液阳性率高于梅毒临床治愈组，为减少神经梅毒的误诊及漏诊，脑脊液实验室检测必须作为梅毒血清固定患者的临床诊疗常规。