Correlation between 3 years prognosis and protein content in the cerebrospinal fluid of patients with neurosyphilis
10.3760/cma.j.issn.1671-8925.2013.02.017
- VernacularTitle:神经梅毒脑脊液蛋白含量与3年远期预后相关研究
- Author:
Yan TAN
1
,
2
;
Li-Juan WANG
;
Yu-Hu ZHANG
;
Ya-Xiu FANG
;
Le HOU
Author Information
1. 510010广州,南方医科大学研究生学院
2. 510370 广州市脑科医院神经内科
- Keywords:
Neurosyphilis;
Long-term prognosis;
Cerebrospinal fluid
- From:
Chinese Journal of Neuromedicine
2013;12(2):183-186
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the related factors of long-term prognosis in patients with neurosyphilis and the correlation between protein content in the cerebrospinal fluid and their prognosis.Methods Forty-five patients with neurosyphilis,admitted to our hospital from June 2006 to May 2009and treated with penicillin standardly during the whole course,were chosen in our study.Rapid plasma reagin test (RPR) and treponema pallidum gelatin particle agglutination test (TPPA) were performed in the serum and cerebrospinal fluid of all the patients; meanwhile,mini-mental state examination (MMSE)and activityof daily living (ADL) scale were scored at admission,6-month and 3-year after treatment.According to the effect of drug therapy,they were divided into two groups (disease-worsened group and disease-not-worsened group).Logistic regression and Pearson correlation analyses were used to estimate the factors related to disease worsen and long-term prognosis.Results In the 41 patients completed 3 years of follow-up,30 (73.2％) patients improved; 25 (61.0％) of them had worsened diseases during 6 month to 1 year after treatment; the other 16 were without disease worsen.Serum TPPA of all patients were positive during the 3 years of follow up.No significant differences in the serum and cerebrospinal fluid RPR titer or MMSE scores were noted between two groups at admission (P＞0.05); however,the cerebrospinal fluid protein of patients in the disease-worsened group was significantly higher than that of patients in disease-not-worsened group (P＜0.05),and the scores of MMSE and ADL scale were significantly worse than those of patients in disease-not-worsened group at 6 month and 3 year after treatment (P＜0.05); the serum RPR titer showed no obvious difference between the two groups at 6month or 3 year after treatment (P＞0.05).Logistic regression analysis showed that increased cerebrospinal fluid protein level was related to the worse of disease (P=-0.023,OR=3.336).Factors closely related to the long-term prognosis included cerebrospinal fluid RPR titer at admission (r=0.384,P=-0.013),cerebrospinal fluid protein content (r=0.612,P=-0.000) and scores of MMSE at admission (r=-0.651,P=0.000).Conclusion About 61％ of patients with neurosyphilis are worsen one year after being treated by penicillin G,but most of patients can improve at 3 year after repeated penicillin G treatment during the whole course; close relation between cerebrospinal fluid protein content and prognosis is noted:the higher the cerebrospinal fluid protein content,the poorer the prognosis and the worsen the illness; no relation between serum RPR titer and both severity of illness and long-term prognosis is noted.
