梅毒血清反应素滴度在神经梅毒腰穿指征中的作用

发布时间：2018-01-30 08:59

本文关键词： 梅毒神经梅毒快速血浆反应素试验腰穿　出处：《中国皮肤性病学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨HIV阴性的梅毒患者血清RPR滴度与神经梅毒的关系。方法回顾性分析2005年6月-2013年10月363例进行腰穿的HIV阴性梅毒患者的数据。应用卡方检验和逻辑回归分析神经梅毒的危险因素,应用ROC曲线分析血清反应素对神经梅毒的诊断价值。结果男性(OR 3.91,95%CI2.49~6.13,P0.001)及血清RPR滴度与神经梅毒显著相关。血清RPR滴度每增高2倍,发生神经梅毒的几率增高1.39倍(校正OR 1.39,95%CI 1.24~1.55,P0.001)。血清RPR滴度1∶16诊断神经梅毒时约登指数(0.288)最大,敏感性和特异性分别为43.70%和85.10%。血清RPR滴度诊断神经梅毒的ROC曲线面积为0.680。结论在HIV阴性人群中,尽管血清RPR滴度与神经梅毒显著相关,但以血清RPR滴度诊断神经梅毒容易造成大量患者的漏诊,其不适合作为判断是否需要进行腰穿的指标。
[Abstract]:Objective to investigate the relationship between serum RPR titer and neurosyphilis in patients with HIV negative syphilis. Methods retrospective analysis was made on 363 cases of HIV negative syphilis who underwent lumbar puncture from June 2005 to October 2013. Risk factors for neurosyphilis using chi-square test and logistic regression analysis. ROC curve was used to analyze the diagnostic value of serum reactive hormone in neurosyphilis. Results the male OR 3.91 ~ 95% CI 2.49 ~ 6.13. P0.001) and serum RPR titer were significantly correlated with neurosyphilis. The rate of neurosyphilis increased by 1.39 times with the increase of serum RPR titer by 2 times (adjusted OR 1.39). 95 CI 1.24 ~ 1.55U P 0.001g. The highest RPR titer was 0.288 when the serum RPR titer was 1:16 for the diagnosis of neurosyphilis. The sensitivity and specificity were 43.70% and 85.10.The area of ROC curve for the diagnosis of neurosyphilis with serum RPR titer was 0.680.Conclusion in HIV negative population. Although the titer of serum RPR is significantly correlated with neurosyphilis, the diagnosis of neurosyphilis by serum RPR titer is easy to cause a large number of patients to miss diagnosis, and it is not suitable to be used as an index to judge the need for lumbar puncture.
【作者单位】：福建省卫生职业技术学院医学技术系;厦门市湖里区妇幼保健院;厦门大学附属中山医院;
【基金】：福建省卫生厅青年科研资助计划(2013-2-90) 福建省医学创新课题项目(2014-CXB-40) 国家自然科学基金青年科学基金项目(81301501)
【分类号】：R759.1
【正文快照】： 表1 222例神经梅毒患者不同临床类型的分布Tab.1 Characteristics of different clinical phases among 222 NS patientsClinical phase Case(%)Male Female Average age(Year)Asymptomatic NS 44(19.82)29 15 51.90Syphilitic meningitis 38(17.12)26 12 49.40Meningovascula

【相似文献】