摘要
目的 回顾性分析神经梅毒患者实验室检测结果,探究神经梅毒发病的危险因素.方法 纳入2020年5月至2023年2月期间,就诊于北京地坛医院的188例梅毒患者为研究对象,其中神经梅毒组124例、梅毒(非神经梅毒)组64例,比较两组患者性别、年龄、脑脊液和血清实验室检测结果.结果 神经梅毒组患者年龄、男性患者比例均高于梅毒组,差异有统计学意义(P均<0.05);神经梅毒组脑脊液中蛋白、白细胞、TPPA阳性率、TRUST阳性率、FTA-ABS IgG阳性率、潘氏试验阳性率及血清FTA-ABS IgM阳性率、TRUST滴度分布均高于梅毒组,差异有统计学意义(P均<0.05);与梅毒组相比,神经梅毒组NLR升高、LMR降低,主要表现在淋巴细胞计数降低,特别是CD4+T淋巴细胞明显降低,差异有统计学意义(Z=2.717,P<0.05);性别(男性相较于女性)(OR=2.660,95%CI:1.084～6.527,P=0.033)、年龄(OR=1.058,95%CI:1.023～1.095,P=0.001)、脑脊液蛋白(OR=1.047,95%CI:1.010～1.085,P=0.013)、脑脊液白细胞(OR=1.257,95%CI:1.102～1.434,P=0.001)、血清TRUST>1:8(OR=3.461,95%CI:1.123～10.665,P=0.031)可能是神经梅毒的独立危险因素.结论 性别(男性)、高龄、脑脊液蛋白和白细胞升高及血清TRUST滴度>1:8是提示疾病进展为神经梅毒的高危因素.
Abstract
Objective To retrospectively analyze the laboratory test results of neurosyphilis pa-tients and to explore the risk factors.Methods A total of 188 syphilis patients who were admitted to Beijing Ditan Hospital from May 2020 to February 2023 were enrolled into this study,and they were divided into the neurosyphilis group(124 cases)and the syphilis(non-neurosyphilis)group(64 cases).The gender,age and laboratory test results of cerebrospinal fluid and serum were compared between the two groups.Results The age and proportion of male patients in the neurosyphilis group were higher than those in syphilis group,and the differences were statistically significant(P<0.05);The levels of protein,leukocyte,positive rates of TPPA,TRUST,FTA-ABS IgG,Pan's test in cerebrospinal fluid,and positive rates of FTA-ABS IgM,TRUST titer distribution in serum which in the neurosyphilis group were higher than those in syphilis group,and the differences were statistically significant(P<0.05).Compared with the syphilis group,the NLR was higher and the LMR was lower in the neurosyphilis group,which was mainly manifested in the decrease of lymphocyte count,especially CD4+T lymphocyte,and the differences were statistically significant(Z=2.717,P<0.05).Gender(male vs.female)(OR=2.660,95%CI:1.084～6.527,P=0.033),age(OR=1.058,95%CI:1.023～1.095,P=0.001),cerebrospinal fluid protein(OR=1.047,95%CI:1.010～1.085,P=0.013),cerebrospi-nal fluid leukocyte(OR=1.257,95%CI:1.102～1.434,P=0.001),serum TRUST>1∶8(OR=3.461,95%CI:1.123～10.665,P=0.031)may be independent risk predictors for Neurosyphilis.Conclusion Gender(male),advanced age,the elevated level of cerebrospinal fluid protein and white blood cells,and serum TRUST>1∶8 suggest high risk factors for neurosyphilis.
NETL
NSTL
万方数据