28例麻痹性痴呆型神经梅毒临床分析

发布时间：2018-05-03 14:52

本文选题：麻痹性痴呆 + 神经梅毒　；参考：《重庆医学》2017年28期

【摘要】：目的探讨麻痹性痴呆型神经梅毒患者的临床特点。方法回顾性分析28例麻痹性痴呆型神经梅毒的临床表现、实验室检查、影像学结果及治疗方案与效果。结果患者以中老年男性为主,临床表现以精神异常、人格改变、智力障碍为主;血清甲苯胺红不加热试验(TRUST)及梅毒螺旋体明胶颗粒凝集试验(TPPA)均阳性;脑脊液TRUST及TPPA全部呈阳性,全部患者脑脊液白细胞计数大于或等于10×106/L,蛋白质大于或等于0.45g/L;14例行脑电图检查,其中轻中度脑电图异常10例,正常4例;26例行MRI检查,发现幕上弥漫脑萎缩22例,多发脑白质脱髓鞘灶16例,脑动脉硬化3例,脑梗死1例。全部患者经过规范化驱梅治疗后,大部分临床症状有不同程度的改善。结论麻痹性痴呆型神经梅毒患者临床表现不一,需要结合实验室及影像学结果综合分析,早期诊断、足量治疗可以明显改善患者预后。
[Abstract]:Objective to investigate the clinical features of paralytic dementia neurosyphilis. Methods 28 cases of palsy dementia neurosyphilis were retrospectively analyzed. Results the main clinical manifestations of the patients were mental disorders, personality changes, mental disorders, serum toluidine red unheated test trust) and Treponema pallidum gelatin particle agglutination test (TPPA). Cerebrospinal fluid (CSF) TRUST and TPPA were all positive. The CSF white blood cell count was greater than or equal to 10 脳 106 / L, and the protein was greater than or equal to 0.45 g / L ~ (-1) in 14 cases of EEG. 10 cases were mild to moderate abnormal EEG, and 4 cases were normal in 4 cases (26 cases) with MRI. There were 22 cases of diffuse supratentorial brain atrophy, 16 cases of multiple white matter demyelination, 3 cases of cerebral arteriosclerosis and 1 case of cerebral infarction. After standardized treatment, most of the patients' clinical symptoms were improved to some extent. Conclusion the clinical manifestations of patients with paralytic dementia neurosyphilis are different. It is necessary to analyze the results of laboratory and imaging, early diagnosis and adequate treatment can obviously improve the prognosis of patients with neurosyphilis.
【作者单位】：南方医科大学珠江医院皮肤科;
【基金】：广东省科技发展专项基金资助资金(2016A020228006)
【分类号】：R759.13

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