Bekkelund S I, Grønli O, Johnsen S H
Nevrologisk avdeling, Regionsykehuset i Tromsø, 9038 Tromsø.
Tidsskr Nor Laegeforen. 2001 Mar 10;121(7):786-8.
Syphilis serology is analysed in all patients admitted as in-patients to the Department of Neurology in Tromsø. In this study we examined the utility of performing routine laboratory testing for syphilis in neurological patients.
We registered all in-patients in the Department of Neurology with a confirmed diagnosis of syphilis during a ten-year period (1990-1999). Additionally, we calculated the cost of performing laboratory tests of all hospitalised patients in this period.
From a total of 8,637 patients, we identified five patients with syphilis, one of them with neurosyphilis. This patient had impaired cognitive functions at the time of admittance and a broad spectrum of neurological deficits suggesting a serious neurological disease. A positive syphilis serology confirmed the diagnosis and treatment was initiated. The mean cost for Treponema pallidum serological screening in neurological patients during 10 years was calculated to be about NOK 17,000 per year.
Tertiary syphilis is a serious disease with symptoms often mimicking other diseases. Although the laboratory tests for syphilis have been performed in every in-patient admitted to the neurological ward, a speedier diagnosis of neurosyphilis could not be detected in any patient in a ten-year hospital material. Routine serological examination for syphilis in neurological patients is therefore not recommended in this geographical area.
对特罗姆瑟大学医院神经科所有住院患者进行梅毒血清学分析。在本研究中，我们检测了对神经科患者进行梅毒常规实验室检测的效用。
我们登记了神经科在十年期间（1990 - 1999年）确诊为梅毒的所有住院患者。此外，我们计算了这一时期所有住院患者进行实验室检测的费用。
在总共8637名患者中，我们识别出5名梅毒患者，其中1名患有神经梅毒。该患者入院时认知功能受损，并有广泛的神经功能缺损，提示患有严重的神经疾病。梅毒血清学检测呈阳性确诊了病情，并开始进行治疗。计算得出10年间神经科患者梅毒螺旋体血清学筛查的平均费用约为每年17000挪威克朗。
三期梅毒是一种严重疾病，其症状常与其他疾病相似。尽管对神经科病房的每一位住院患者都进行了梅毒实验室检测，但在十年的医院病例资料中，没有任何患者能更快地诊断出神经梅毒。因此，在该地区不建议对神经科患者进行梅毒常规血清学检查。
