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目的检测经过治疗但RPR持续阳性两年以上无神经损害临床表现的梅毒患者脑脊液中梅毒抗体与外周血淋巴细胞亚群,并探讨其相关性。方法应用梅毒血清学试验等方法对46例HIV阴性的这类梅毒患者的脑脊液进行梅毒抗体检测;同时应用流式细胞仪检测这些患者外周血淋巴细胞亚群,并与5例未治神经梅毒的脑脊液进行梅毒抗体检测结果和30例健康人群的外周血检测结果相对照。结果46例患者脑脊液中,有12例(27.39%)存在梅毒抗体,5例神经梅毒的脑脊液均存在梅毒抗体。患者外周血CD3+、CD4+T细胞及自然杀伤细胞与健康人群的检测结果差异无显著性(P>0.05),而CD8+T细胞明显高于对照组,差异有显著性(P<0.001);脑脊液梅毒抗体阳性和阴性梅毒患者之间,外周血淋巴细胞亚群检测结果差异无显著性(P>0.05)。结论经过治疗但RPR持续阳性梅毒患者脑脊液存在梅毒抗体,表明部分患者存在无症状神经梅毒;经过常规治疗但RPR持续阳性梅毒患者存在细胞免疫缺陷;无症状神经梅毒与外周血细胞免疫异常无明显的相关性。
Objective To detect the syphilis antibody and peripheral blood lymphocyte subsets in CSF of syphilis patients who have been treated but whose RPR persistently remains positive for more than two years without neurological damage and to explore their correlation. Methods The syphilis antibody was detected in 46 patients with HIV-negative syphilis using syphilis serological test. The peripheral blood lymphocyte subsets of these patients were detected by flow cytometry, and were compared with 5 cases without neurosyphilis Cerebrospinal fluid syphilis antibody test results and 30 healthy people in the peripheral blood test results compared. Results In 46 patients, 12 (27.39%) had syphilis antibody in cerebrospinal fluid and 5 in syphilis. There were no significant differences in the detection results of CD3 +, CD4 + T cells, natural killer cells and healthy people (P> 0.05), but the level of CD8 + T cells was significantly higher in the patients than in the control group (P <0.001). There was no significant difference in peripheral blood lymphocyte subsets between patients with CSF positive syphilis antibody and negative syphilis (P> 0.05). Conclusions Syphilis antibodies are present in the cerebrospinal fluid of patients with persistent RPR positive for RPR after treatment, indicating that asymptomatic neurosyphilis exists in some patients. After routine treatment, patients with RPR persistent positive syphilis have cellular immunodeficiency. Asymptomatic neurosyphilis has no significant correlation with peripheral blood cell immune abnormalities Sex.