Tremont-Lukats I W, Teixeira G M, Hernández D E
Departamento de Neurología, Universidad de Wisconsin, Madison, USA.
Gac Med Mex. 1999 Mar-Apr;135(2):101-6.
This study estimated the frequency and assessed the clinical value of nine primitive reflexes (PR) in 78 AIDS cases, comparing them with 81 matched, seronegative controls. All subjects were evaluated with a standardized neurologic examination that included a Mini-Mental State Exam (MMSE). Fifty-six percent had cognitive impairment and PR. Overall, PR were 2-36 times more frequent in cases. Such association was univariately stronger for the glabellar, snout, and Rossolimo signs. Ninety-two percent of cases had > or = 2 PR vs. 8% of controls, who had up to 2 PR (p < 0.0001; 95 CI: 68% to 100%). We were able isolate or show opportunistic pathogens in CSF of 4 out of 43 cases. This study supports the association of PR to cognitive decline in patients with AIDS. Larger, long term follow-up studies with multivariate analysis in Latin America are needed to identify the PR that can serve as reliable indicators of human immunodeficiency virus type 1 (HIV-1)-associated cognitive/motor complex.
本研究评估了78例艾滋病患者中九种原始反射（PR）的出现频率，并评估了其临床价值，同时与81名匹配的血清阴性对照进行比较。所有受试者均接受了包括简易精神状态检查（MMSE）在内的标准化神经学检查。56%的患者存在认知障碍和原始反射。总体而言，艾滋病患者中原始反射的出现频率比对照组高2至36倍。这种关联在眉间反射、噘嘴反射和罗索利莫征中更为显著。92%的艾滋病患者有≥2种原始反射，而对照组只有8%有至多2种原始反射（p<0.0001；95%置信区间：68%至100%）。在43例患者中，有4例脑脊液中可分离出或检测到机会性病原体。本研究支持原始反射与艾滋病患者认知功能下降之间的关联。需要在拉丁美洲开展更大规模的长期随访研究，并进行多变量分析，以确定可作为1型人类免疫缺陷病毒（HIV-1）相关认知/运动复合体可靠指标的原始反射。
