van de Ree M A, Stam J, Hische E A, van Ketel R J
Afd. Neurologie, Academisch Medisch Centrum, Amsterdam.
Ned Tijdschr Geneeskd. 1992 Jul 11;136(28):1356-9.
In a retrospective study the results of the screening for syphilis in one of the neurological wards of the Academic Medical Centre in Amsterdam were analysed. The Venereal Disease Research Laboratory test (VDRL) and the Treponema Pallidum Haemagglutination Assay (TPHA) in serum were used for screening. The data for analysis were obtained via the hospital computer data base and via the medical files of the department of neurology. During the 5-year study period (1986-1990) 2378 adult patients were admitted and 1247 (52.4%) of them were screened. In seven (0.56%) patients both tests were positive. Three of them had been treated for syphilis in the past and showed no symptoms of active syphilis. Four (0.32%) patients suffered from active neurosyphilis. In three of these four patients syphilis was suspected on admission and confirmed by the tests. In one patient the diagnosis of syphilis was not considered. The positive test results became available shortly before she died of pneumonia and were without consequences. None of the 32 (2.6%) patients with a positive TPHA and a negative VDRL was diagnosed as having (neuro-)syphilis. Two (0.16%) patients had a false-positive VDRL. We conclude that routine serological examination for syphilis of every patient admitted to a neurological ward is not useful. We advise a limited screening of patients who belong to a group with high risk for syphilis and patients with symptoms and signs that can be caused by syphilis, such as dementia or ischaemic strokes at a relatively young age.
在一项回顾性研究中，对阿姆斯特丹学术医疗中心某神经内科病房梅毒筛查结果进行了分析。血清中的性病研究实验室试验（VDRL）和梅毒螺旋体血凝试验（TPHA）用于筛查。分析数据通过医院计算机数据库和神经科的病历获得。在为期5年的研究期间（1986 - 1990年），收治了2378例成年患者，其中1247例（52.4%）接受了筛查。7例（0.56%）患者两项检查均呈阳性。其中3例过去曾接受梅毒治疗，无活动性梅毒症状。4例（0.32%）患者患有活动性神经梅毒。在这4例患者中的3例，入院时怀疑患有梅毒并经检查确诊。1例患者未考虑梅毒诊断。阳性检查结果在她死于肺炎前不久才出来，未造成影响。32例（2.6%）TPHA阳性而VDRL阴性的患者均未被诊断为患有（神经）梅毒。2例（0.16%）患者VDRL出现假阳性。我们得出结论，对神经内科病房收治的每位患者进行梅毒常规血清学检查并无用处。我们建议对属于梅毒高危人群以及有梅毒可能引发的症状和体征（如痴呆或相对年轻时的缺血性中风）的患者进行有限的筛查。
