以首发精神症状的神经梅毒患者临床特征分析
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摘要
目的总结以精神症状为首发神经梅毒患者的临床特点,为临床早期确诊神经梅毒提供线索。方法回顾性分析25例神经梅毒患者的精神病性症状。结果 25例患者中,误诊16例,主要误诊为双相情感障碍、精神分裂症、分裂样精神病、阿尔茨海默病、精神发育迟滞;精神病性症状共有25例,情感症状20例,认知功能改变22例,人格改变16例。结论首发精神症状的神经梅毒精神病性症状丰富,误诊率高,及时治疗能够改善精神症状。
Objective To summarize the clinical feature of onset of psychotic symptoms in neurosyphilis patients,and assist the diagnose of neurosyphilis. Methods Retrospetcive analysis the psychotic symptoms in 25 neurosyphilis patients. Results There are 16 misdiagnosis,which were diagnosed as bipolar disorder,schizophrenia,schizophrenic psychosis,AD,mental retardation.25 onset symptoms are psychotic symptoms,20 are affective symptoms,cognition decline are 22,personality abnormal are 16. Conclusion The psychiatric symptoms are varies in neurosyphilis patients and often misdiagnosed,and can be improved after treatment.
Objective To summarize the clinical feature of onset of psychotic symptoms in neurosyphilis patients,and assist the diagnose of neurosyphilis. Methods Retrospetcive analysis the psychotic symptoms in 25 neurosyphilis patients. Results There are 16 misdiagnosis,which were diagnosed as bipolar disorder,schizophrenia,schizophrenic psychosis,AD,mental retardation.25 onset symptoms are psychotic symptoms,20 are affective symptoms,cognition decline are 22,personality abnormal are 16. Conclusion The psychiatric symptoms are varies in neurosyphilis patients and often misdiagnosed,and can be improved after treatment.
引文
1.李满棠,黄波,李刚。神经梅毒46例临床分析。广东医学院学报,2016;34(6):658-660.
2 .Luo X,Shi H,Hou L,et al.Different cerebrospinal fluid levels of Alzheimer-type biomarker Abeta42 between general paresis and asymptomatic neurosyphilis.European Journal Neurology,2015;22(5):853-858.
3 .郝良宸,车雅敏,黄士纲,等。梅毒1219例临床流行病学分析。临床皮肤科杂志,2013;42(10):587-589.
4 .龙海英,巩凤芹,王红星。首次就诊于精神科的神经梅毒病例特征分析。山西医科大学学报,2010;41(4):355-357.
5 .Ghanem KG.Neurosyphilis:A Historical Perspective and Review.CNS Neuroscience&Therapeutics,2010;16:e157-e168.
6 .龚向东,岳晓丽,滕菲,等。2000-2013年中国梅毒流行特征与趋势分析。中华皮肤科杂志,2014;47:310-315.
7 .Friedrich F,Aigner M,Fearns N,et al.Psychosis in neurosyphilis clinical aspects and implications.Psychospatholgy,2014;47(1):3-9.
8 .Bhai S,Lyons JL.Neurosyphilis Upate:Atypical is the New Typical.Current Infection Disease Reports,2015;17(5):481.
9 .顾春红,钱铭,姚琳,等。以精神症状为首发的32例神经梅毒的分析研究。国际精神病性学杂志,2017;44(4):640-642.
10 .胡满基,陈圣祺,伍毅,等。对国内394例神经梅毒病例荟萃分析。四川精神卫生,2012;25(1):14-17.
11 .Wu WM,Zou SH,Tong GY,et al.Probe into correlation between impulsive aggressive behavior and cognitive impairment in patients with bipolar disorders.Journal of Psychiatry and Brain Science,2016;1(4):1-5.
12 .Liu XB,Xie AM,Li Y,et al.Cognitive Impairment of Chronic Alcohol Dependence and Its Relationship with Prefrontal Cortex.Journal of Psychiatry and Brain Science,2017;2(2):1-5.
13 .刘文彦,吴逸雯,王信义,等。以痴呆为主要表现的神经梅毒、HIV相关性痴呆和克-雅病的临床特征分析。中国现代神经疾病杂志,2012;12(3):342-348.
2 .Luo X,Shi H,Hou L,et al.Different cerebrospinal fluid levels of Alzheimer-type biomarker Abeta42 between general paresis and asymptomatic neurosyphilis.European Journal Neurology,2015;22(5):853-858.
3 .郝良宸,车雅敏,黄士纲,等。梅毒1219例临床流行病学分析。临床皮肤科杂志,2013;42(10):587-589.
4 .龙海英,巩凤芹,王红星。首次就诊于精神科的神经梅毒病例特征分析。山西医科大学学报,2010;41(4):355-357.
5 .Ghanem KG.Neurosyphilis:A Historical Perspective and Review.CNS Neuroscience&Therapeutics,2010;16:e157-e168.
6 .龚向东,岳晓丽,滕菲,等。2000-2013年中国梅毒流行特征与趋势分析。中华皮肤科杂志,2014;47:310-315.
7 .Friedrich F,Aigner M,Fearns N,et al.Psychosis in neurosyphilis clinical aspects and implications.Psychospatholgy,2014;47(1):3-9.
8 .Bhai S,Lyons JL.Neurosyphilis Upate:Atypical is the New Typical.Current Infection Disease Reports,2015;17(5):481.
9 .顾春红,钱铭,姚琳,等。以精神症状为首发的32例神经梅毒的分析研究。国际精神病性学杂志,2017;44(4):640-642.
10 .胡满基,陈圣祺,伍毅,等。对国内394例神经梅毒病例荟萃分析。四川精神卫生,2012;25(1):14-17.
11 .Wu WM,Zou SH,Tong GY,et al.Probe into correlation between impulsive aggressive behavior and cognitive impairment in patients with bipolar disorders.Journal of Psychiatry and Brain Science,2016;1(4):1-5.
12 .Liu XB,Xie AM,Li Y,et al.Cognitive Impairment of Chronic Alcohol Dependence and Its Relationship with Prefrontal Cortex.Journal of Psychiatry and Brain Science,2017;2(2):1-5.
13 .刘文彦,吴逸雯,王信义,等。以痴呆为主要表现的神经梅毒、HIV相关性痴呆和克-雅病的临床特征分析。中国现代神经疾病杂志,2012;12(3):342-348.