摘要：

目的 分析天津市环湖医院神经梅毒的流行病学特征。方法 回顾性分析天津市环湖医院 2012-2017 年诊断与治疗的 138 例神经梅毒患者的流行病学资料、实验室和影像学特征。结果 将138 例神经梅毒患者分为无症状性神经梅毒（无症状组，32 例）、间质性神经梅毒（间质组，46 例）和实质性神经梅毒（实质组，60 例）。实质组男性患者比例（χ² = 9.623，P = 0.002；χ² = 7.953，P = 0.005）和年龄（t = 2.985，P = 0.004；t = 3.322，P = 0.001）均高于无症状组和间质组；间质组（Z = 2.394，P = 0.024）和实质组（Z = 2.937，P = 0.004）快速血浆反应素试验滴度高于无症状组；实质组蛋白定量高于无症状组（t = 2.453，P = 0.017）。无症状组患者影像学无特异性表现；间质组有 22 例影像学异常，主要表现为脑梗死；实质组有 28 例影像学异常，主要表现为脑缺血、脑白质变性和脱髓鞘、脑积水。结论 神经梅毒好发于男性和受教育程度较低人群，临床和影像学表现多样，应加强高危人群健康教育和行为干预措施，以降低神经梅毒发生率。

关键词: 神经梅毒, 流行病学, 天津

Abstract:

Objective To analyze the epidemiological characteristics of neurosyphilis in Tianjin Huanhu Hospital. Methods The epidemiological data, laboratory examination results and neuroimaging features of 138 patients with neurosyphilis who were diagnosed and treated in our hospital from 2012 to 2017 were retrospectively analyzed. Results All patients were divided into asymptomatic neurosyphilis (asymptomatic group, N = 32), interstitial neurosyphilis (interstitial group, N = 46) and parenchymatous neurosyphilis (parenchymatous group, N = 60). The proportion of male patients (χ² = 9.623, P = 0.002; χ² = 7.953, P = 0.005) and age (t = 2.985, P = 0.004; t = 3.322, P = 0.001) of parenchymatous group were higher than those of asymptomatic group and interstitial group. The rapid plasma reagin (RPR) titers of interstitial group (Z = 2.394, P = 0.024) and parenchymatous group (Z = 2.937, P = 0.004) were higher than that of asymptomatic group. The protein quantification of parenchymatous group was higher than that of asymptomatic group (t = 2.453, P = 0.017). The imaging findings of patients in asymptomatic group showed no abnormalities. The imaging findings of 22 patients in interstitial group showed cerebral infarction, while the other one did not show abnormality. The imaging findings of 28 patients in parenchymatous group showed abnormalities such as cerebral ischemia, white matter degeneration, demyelination and hydrocephalus, while the other 7 patients did not show abnormality. Conclusions Neurosyphilis is more common in men and lower education people, which has complex and diverse clinical features and imaging manifestations. It is necessary to strengthen the measures of health education and behavior intervention in high-risk population, so as to reduce the incidence of neurosyphilis.

Key words: Neurosyphilis, Epidemiology, Tianjin