Test Of Cerebrospinal Fluid In Patients With Syphilis Serum-resistance

Syphilis is caused by treponema pallidum which is one of main sexual transmitted disease (STD) in our country. The patient in syphilis has been formal treatment, clinical symptoms disappeared, the serological tests for syphilis may be negative to 3-6 months. However, in clinical work, we have usually discover some patients with clinical symptoms completely disappeared after treatment, but the process of follow-up serological test is still positive for a long time, that is serum-resistance. In recent years, the incidence of syphilis tends to rise year by year, with the increase in its incidence, the phenomenon of serum-resistance is increasing.The syphilis patients with serum-resistance bring difficulty into their treatment, because their serum-reaction will be positive even if they receive several times of regular therapy. The serum-resistance phenomenon in syphilis patients had attracted much attention of international scientists. It was not clear yet why some patients show permanent positive. Generally, the body cell immune system or the latent syphilis in central nervous system was considered responsible for this reaction. So far, the study of the syphilis serum-resistance focused on cellular immune function, while remaining on the central nervous system is little research of Treponema pallidum.Objective: The subject for syphilis by detecting cerebrospinal fluid in patients with serum-resistance, to observe whether the central nervous system involvement, to explore the pathogenesis of the serum-resistance, and to effectively carry out the prevention and treatment of the disease.Methods: 25 cases patients have been diagnosed with serum-resistance lumbar puncture for cerebrospinal fluid samples for convention, biochemistry, immunology, cytology and rapid plasma regain test (RPR),treponema pallidum hemagglutination assay(TPHA).Results:1. Test of cerebrospinal fluid in 25 cases patients with syphilis serum-resistance, Seventeen cases was abnormal, accounting for 68%;2. Conventional: one cases of yellow color; Pandy test weakly positive in one case, positive in two cases; increased from four cases of leukocytes, namely 16/uL, 12/uL, 18/uL, 11/uL;3. Biochemistry: two cases of trace protein increased, namely 0.62g/L, 0.71g/L; CL^-dropped in eleven cases, in the 111-119mmol/L, accounting for 44%;4. Immunity: IgG increased from seven cases: 0.04g/L in five cases, 0.06g/L in two cases;5. Cytology: seven cases were abnormal, the lymphocytes in four cases, the lymphatic-monocyte in three cases;6. One patient was reactive to rapid plasma reagent test (RPR); and treponema pallidum hmagglutination assay (TPHA) was positive too.7. All of Pressure of cerebrospinal fluid was normal, in the 80-145mmH₂O.Conclusion: The detection of cerebrospinal fluid in patients with serum-resistance were abnormal, indicating that the nervous system involved may be one of the reasons why patients with serum-resistance .