HIV阳性与HIV阴性神经梅毒临床特点的比较

闫俊　　王梦嫣　　张忠东　　师金川　　张斌海　　万虎　　杨宗兴

[關键词] 人类免疫缺陷病毒;非人类免疫缺陷病毒;神经梅毒;临床特点

[中图分类号] R759.13          [文献标识码] A          [文章编号] 1673-9701（2021）21-0022-04

Comparison of clinical features between HIV-positive and HIV-negative neurosyphilis

YAN Jun   WANG Mengyan   ZHANG Zhongdong   SHI Jinchuan   ZHANG Binhai   WAN Hu   YANG Zongxing

Department Ⅱ of Infectious Disease， Xixi Hospital of Hangzhou City， Hangzhou   310023， China

[Abstract] Objective To compare the clinical features of HIV-positive and HIV-negative neurosyphilis. Methods Patients with HIV-positive and HIV-negative neurosyphilis admitted to our hospital from January 2013 to December 2019 were retrospectively included. Clinical data such as general condition， history of syphilis treatment， course of disease， laboratory test results， and neurosyphilis classification of patients were collected and analyzed statistically. Results There were 375 cases in the HIV-positive group and 141 cases in the HIV-negative group. There were 363 males （96.80%） in the HIV-positive group， which were more than that of 92 males （65.25%） in the HIV-negative group （P<0.001）， and the median age in the HIV-positive group was 35 （30， 42） years， which was younger than that of 56 （48， 64） years in the HIV-negative group （P<0.001）. 282 cases （75.20%） in the HIV-positive group had a reciprocal RPR titer of Log2≥32， which was more than that of 67 cases （45.16%） in the HIV-negative group （P<0.001）. In the HIV-positive group， 260 cases （53.33%） with positive TPPA in cerebrospinal fluid and 53 cases （14.13%） with reciprocal RPR titer ≥ 1 in Log2 cerebrospinal fluid were less than those of 131 cases （92.91%） and 72 cases （51.06%） in the HIV-negative group （P<0.001）. Glucose and chloride in CSF in the HIV-positive group were lower than those in the HIV-negative group （P<0.001）. There were 345 cases （92.00%） asymptomatic neurosyphilis in the HIV-positive group， which were more than that of 60 cases （42.55%） in the HIV-negative group （P<0.001）. There were 8 cases （2.13%） of cerebrovascular inflammation and 7 cases （1.87%） of brain parenchyma in the HIV-positive group， which were less than those of 22 cases （15.60%） and 56 cases （39.72%） in the HIV-negative group （P<0.001）. Conclusion Male patients with HIV-positive neurosyphilis， blood RPR>1∶32 and asymptomatic neurosyphilis were all more than those with HIV-negative neurosyphilis. However， the age， TPPA positive rate in cerebrospinal fluid， RPR positive rate， cell number， protein， glucose， chloride， cerebrovascular type and cerebral parenchyma type of HIV-negative neurosyphilis were all higher than those of the HIV-positive patients.