Analysis of the characteristics of symptomatic and asymptomatic neurosyphilis patients and its treatment effects

Objective To compare the characteristics of symptomatic and asymptomatic neurosyphilis,and provide the basis for the early clinical diagnosis and treatment of neurosyphilis. Methods Total 83 patients with neurosyphilis in our hospital between March 2013 and March 2015 were recruited and randomly assigned into symptomatic group(n=45) and asymptomatic group(n=38) according to the neurological symptoms.All patients once daily received Intravenous infusion of penicillin(24 000 000 U) continuous for two weeks,while weekly intramuscular benzathine(2 400 000 U) continuous for 3 times.The test results of rapid plasma reagin(RPR),cerebrospinal fluid,number of patients receiving the tests,and the improvement of patient’s condition were compared.Student t-test for the quantitative variables and Chi-square test for the categorical variables were performed. Results The white blood cells count (19.4±5.6)×10⁶/L,serum protein level (57.7±14.9)mg/dl,glucose levels (2.7±1.5)mmol/L of symptomatic patients was significantly higher than those of the asymptomatic group,the difference between the two groups was significant(P＜0.05);the glucose level,white blood cell count and intracranial pressure in the cerebrospinal fluid of patients in the symptomatic group was (29.5±5.3)mmol/L,(43.2±13.8)×10⁶/L and (189.4±25.1)mm Hg,respectively,which were significantly higher than those of the asymptomatic group,the difference between the two groups was significant(P＜0.05);In the symptomatic group,27 cases were with the level of cerebrospinal fluid protein ＞50 mg/dl,28 cases with white blood cell count in the cerebrospinal fluid ＞5/mm³, 45 cases with positive serum RPR,45 cases with positive cerebrospinal fluid RPR,all were higher than those in the asymptomatic group,the difference between the two groups was significant(P＜0.05);In the symptomatic group,the symptoms of 95.6% of the patients after the treatment were improved;in the asymptomatic group,the symptoms of 97.4% of the patients were improved after the treatment,there was no significant difference between the two groups(P＜0.05). Conclusion The blood and cerebrospinal fluid indicators are helpful for the diagnosis of neurosyphilis.The penicillin is effective for neurosyphilis,worthy of popularizing in clinical practice.