Analysis Of Clinical Factors Associated With 92 Cases Of Syphilis In Hospital

Objective: With the analysis of the general datas and clinical examination results of the syphilis patients with treatment failure in our hospital dermatologist, it have provided certain theoretical basis for the diagnosis and treatment of syphilis, by summarizing the general variation regularities of syphilis, investigating the results of cerebrospinal fluid examination, especially the TPPA detection which has the important value in neurosyphilis.Methods: A retrospective clinical data of 92 cases of patients with late syphilis in our hospital from January 2010 to October 2014 have been collected, and all results have been divided into antibody-positive group(29 cases) and antibody-negative group(63 cases) by the results of cerebrospinal fluid TPPA. The data of age, gender, disease duration, previous therapy, imaging data, and CSF serology test results and other factors between the two groups have been analzed.Results: 1 Clinical data:(1) Age: There was no significant difference statistically between the antibody-positive group(37.03 ± 12.50 years)and the antibody-negative group(34.49 ± 10.23 years) in the average age(t = 0.96, P> 0.05).(2) Gender: There had difference statistically between the antibody-positive group(13 males and 16 females) and the antibody-negative group(14 males and 49 females) in gender(X2=4.89,P<0.05).(3)The duration: There was no significant difference statistically between the antibody-positive group(2.65±1.59 years)and the antibody-negative group(2.11±2.12 years) in the course after infection(t =1.22, P>0.05).(4)Privious therapy: There existed statistical difference between the two groups(X2=4.89, P<0.05), which had 11 cases with formal treatment in antibody-positive group and 38 cases in antibody-negative group. 2 Laboratory tests:(1) There had significant difference statistically between the antibody-positive group(52.51±29.98 mg/dl)and the antibody-negative group(36.05±15.58 mg/dl) in the content of cerebrospinal fluid protein(t=3.45,P<0.01).(2)There was no difference statistically between the two groups in the average count of CSF leukocyte(t=0.75,P>0.05), the antibody-positive group of 52.51±29.98 mg/dl and the antibody-negative group of 36.05 ± 15.58 mg/dl.(3) There was no difference statistically between the two groups in the average count of glucose, 8 cases of abnormal count of glucose in the antibody-positive group and 14 cases of abnormal count of glucose in the antibody-negative group(X2=0.314,P>0.05).(4) There was no difference statistically between the two groups in the average count of LDH in cerebrospinal fluid, 5 cases of abnormal count of LDH in the antibody-positive group and 9 cases of abnormal count in the antibody- negative group(X2=0.314,P>0.05).(5)There was no difference statistically between the two groups in the average count of ADA in cerebrospinal fluid, 11 cases of positive in the antibody-positive group and 23 cases of abnormal count in the antibody-negative group(X2=0.017,P>0.05).(6) There was no difference statistically between the two groups in the Pandy test of cerebrospinal fluid, 7 cases of abnormal count in the antibody-positive group and 11 cases of positive in the antibody-negative group(X2=0.563,P>0.05).(7) There had statistical difference between the two groups in the serology RPR titers, 22 cases of RPR ≤1: 4 in the antibody-positive group and 28 cases of RPR ≤1: 4 in the antibody-negative group(X2=7.900,<0,01). 3 Imageology:(1) There was no difference statistically between the two groups in the cerebral MRI, 8 cases of abnormality in the antibody-positive group and 14 cases of abnormality in the antibody-negative group(X2=0.014,P>0.05).(2) There was no difference statistically between the two groups in the heart doppler ultrasound, 8 cases of abnormality in the antibody-positive group and 19 cases of abnormality in the antibody-negative group(X2=0.014,P>0.05).Conclusion: 1 The risk factors of nervous system damage have included informal treatment of syphilis, serology RPR high titers(>1:4) and higher protein content in the cerebrospinal fluid; 2 The positive of TPPA in cerebrospinal fluid has a certain reference value for the diagnosis of neurosyphilis.