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中华实验和临床感染病杂志(电子版)

中华实验和临床感染病杂志(电子版) ›› 2018, Vol. 12 ›› Issue (04) : 354 -359. doi: 10.3877/cma.j.issn.1674-1358.2018.04.008

所属专题： 文献；

论著

梅毒合并脑梗死患者有无动脉粥样硬化危险因素的临床特征
秦开宇1, 马小扬1, 伍文清1,†(), 黄宇明1, 许东梅1   
  1. 1. 100015　北京，首都医科大学附属北京地坛医院神经内科
  • 收稿日期:2017-11-06 出版日期:2018-08-15
  • 通信作者: 伍文清

Clinical characteristic of patients with syphilis and cerebral infarction complicated with and without atherosclerosis risk factors

Kaiyu Qin1, Xiaoyang Ma1, Wenqing Wu1,†(), Yuming Huang1, Dongmei Xu1   

  1. 1. Department of Neurology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
  • Received:2017-11-06 Published:2018-08-15
  • Corresponding author: Wenqing Wu
  • About author:
    Corresponding author: Wu Wenqing, Email:
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引用本文：

秦开宇, 马小扬, 伍文清, 黄宇明, 许东梅. 梅毒合并脑梗死患者有无动脉粥样硬化危险因素的临床特征[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(04): 354-359.

Kaiyu Qin, Xiaoyang Ma, Wenqing Wu, Yuming Huang, Dongmei Xu. Clinical characteristic of patients with syphilis and cerebral infarction complicated with and without atherosclerosis risk factors[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(04): 354-359.

目的

分析梅毒合并脑梗死患者有与无动脉粥样硬化危险因素的差异。

方法

应用病例回顾分析方法收集2015年4月3日～2017年7月28日于首都医科大学附属北京地坛医院就诊的HIV阴性的梅毒合并脑梗死患者共24例，将梅毒合并脑梗死患者分为无动脉粥样硬化危险因素组（8例）与有动脉粥样硬化危险因素组（16例），比较两组患者的一般临床资料及脑血管病变分布、神经梅毒所占比例以及既往有脑梗死病史者比例。

结果

无动脉粥样硬化危险因素组患者平均年龄为（43.0 ± 8.7岁）较有动脉粥样硬化危险因素组患者（58.1 ± 15.2岁）小（t= 2.59、P= 0.016），两组患者均以男性居多，其中无动脉粥样硬化危险因素组患者中男性62.5%；有动脉粥样硬化危险因素组患者中男性75.0%，差异无统计学意义（χ2= 0.40，P= 0.9）。病变血管分布方面，无动脉粥样硬化危险因素组患者较有动脉粥样硬化危险因素组更易累及颅内血管（75.0%vs. 31.3%，χ2= 4.11、P <0.05）。两组患者既往脑梗死病史发生率差异无统计学意义（12.5%vs. 50.0%，χ2= 3.2、P >0.05）。神经梅毒所占比例差异无统计学意义（62.5%vs. 92.9%、χ2= 3.15、P >0.05）。

结论

梅毒合并脑梗死患者无动脉粥样硬化危险因素组平均年龄较小，病变以颅内血管受累为主。

关键词: 梅毒, 动脉粥样硬化, 脑梗死
Objective

To investigate the differences between patients with and without atherosclerosis risk factors of syphilis complicated with cerebral infarction.

Methods

Total of 24 patients of syphilis complicated with cerebral infarction were collected from April 3rd, 2015 to July 28th, 2017 in Beijing Ditan Hospital, Capital Medical University, and were devided into two groups: group with and without atherosclerosis risk factors (8 cases and 16 cases, respectively). The cerebrospinal fluid and CTA, record general information were detected, and the differences between the two groups were compared, respectively.

Results

Patients without atherosclerosis risk factors were younger (43.0 ± 8.7 years old) than cases with atherosclerosis risk factors (58.1 ± 15.2 years old) (t= 2.59,P= 0.016). The preponderance of men exists in both groups, the proportion of male cases was almost equal (62.5%and75.0% of cases without and with atherosclerosis risk factors, respectively), without significant difference (χ2= 0.40, P= 0.9). Intracranial arteries were mainly involved in cases without risk factors (75.0%vs. 31.3%;χ2= 4.11,P< 0.05). Rates of cerebral infarction history had no significant difference (12.5%vs. 50.0%;χ2= 3.2,P> 0.05). The percentage of neurosyphilis between two groups were not statistically significant (62.5%vs. 92.9%;χ2= 3.15,P> 0.05).

Conclusions

Patients of syphilis complicated with cerebral infarction without atherosclerosis risk factors were younger. Intracranial arteries were mainly involved in those patients.

Key words: Syphilis, Atherosclerosis, Cerebral infarction
表1 两组患者的临床特征
指标 无动脉粥样硬化危险因素组（8例） 有动脉粥样硬化危险因素组（16例） 统计量 P值
平均年龄（±s，岁） 43.0 ± 8.7 58.1 ± 15.2 t = 2.59 0.016
性别[例（%）] ? ? χ2= 0.40 0.530
? 男 5（62.5） 12（75.0） ? ?
? 女 3（37.5） 4（25.0） ? ?
病变血管分布[例（%）] 8（100.0） 16（100.0） χ2= 4.11 0.043
? 仅颅内血管 6（75.0） 5（31.3） ? ?
? 颈部血管病变或颈部和颅内血管均有病变 2（25.0） 11（68.8） ? ?
既往存在脑梗死病史[例（%）] 8（100.0） 16（100.0） χ2= 3.20 0.074
? 有 1（12.5） 8（50.0） ? ?
? 无 7（87.5） 8（50.0） ? ?
符合神经梅毒标准[例（%）] 8（100.0） 16（100.0） χ2= 3.15 0.076
? 符合 5（62.5） 13（81.3） ? —
? 脑脊液指标不符合 3（37.5） 1（6.3）a — —
图1 无动脉粥样硬化危险因素组患者的CTA特征
图2 有动脉粥样硬化危险因素组患者的CTA特征
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