以痴呆为突出表现的神经梅毒：系统分析

发布时间：2018-03-24 02:25

本文选题：痴呆　切入点：神经梅毒　出处：《苏州大学》2011年硕士论文

【摘要】：目的:探讨以痴呆为突出表现的神经梅毒的临床特征及其治疗和预后,以提高对该病的诊治水平。方法:结合检索Medline和中国生物医学文献数据库(CBM),对1989年至今(2010年)国内外文献中公开发表的(病例报告形式)以痴呆为突出表现的梅毒患者的病历资料进行回顾性分析。结果:纳入43篇文献共60例患者(59例麻痹性痴呆及1例梅毒性精神神经病),其临床特征包括:①男性多见;②多数隐匿起病;③首发症状以记忆力减退和性格改变多见;④MRI、CT以脑萎缩为主;⑤血和CSF的梅毒抗体检查阳性,也可有特殊情况;⑥确诊较困难;⑦驱梅治疗近期症状可不同程度改善;⑧缺乏远期疗效的随访资料。结论:①麻痹性痴呆和梅毒性精神神经病均可有痴呆表现;②原因不明的痴呆患者应常规行梅毒血清学及脑脊液检查;③驱梅结合对症治疗大多近期疗效好,发生脑萎缩者预后较差;④需长期随访观察其远期疗效。
[Abstract]:Objective: To investigate the clinical characteristics of neurosyphilis typically manifested by dementia and its treatment and prognosis, in order to improve the level of diagnosis and treatment of the disease.
Methods: combined with the retrieval of Medline and the Chinese biomedical literature database (CBM), we retrospectively analyzed the medical records of syphilis patients with dementia manifested by dementia (published in 1989 and 2010).
Results: 43 articles were included in a total of 60 cases of patients (59 cases of paralytic dementia and 1 cases of syphilitic psychoneurosis), including its clinical features: male; the most insidious onset; first symptoms with memory impairment and personality changes; the MRI, CT in cerebral atrophy; syphilis antibody test the blood and CSF positive, also can have the special circumstances; the diagnosis is difficult; the treatment of syphilis symptom can be improved; the lack of follow-up data of long-term curative effect.
Conclusion: both the paralytic dementia and syphilitic psychoneurosis with dementia; dementia of the patients with unknown causes should be routine syphilis serum and cerebrospinal fluid examinations; the syphilis and symptomatic treatments mostly good curative effect, the occurrence of cerebral atrophy is associated with a poor prognosis; the need for long-term follow-up to observe the long-term curative effect.

【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R759.1

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