García-Rodríguez J A, Martín-Sánchez A M, Canut A, García-García L, Cacho J
Servicio de Neurología, Hospital Clínico Universitario, Salamanca.
Enferm Infecc Microbiol Clin. 1990 Jan;8(1):43-7.
The reactivity of 194 samples of CSF against VDRL and FTA-ABS was studied in patients attending the Clinical Hospital in Salamanca over a five years period. This laboratory was asked to rule out an etiology of syphilis. Twelve samples of CSF proved to be reactive (6.2%) against VDRL and/or FTA-ABS. Seven of these corresponded to six adults diagnosed as suffering from neurosyphilis and one to an infant with early congenital syphilis without neurological alterations; these had in common the presence of active syphilis and a reactive FTA-ABS in serum. In the CSF of the six cases of neurosyphilis, VDRL was reactive in two patients (33.3%) and FTA-ABS in five (83.3%). One minimally reactive VDRL and four FTA-ABS were detected in the remaining five patients, with no known previous history of syphilis, that were suffering from different neurological alterations and that had a nonreactive FTA-ABS in serum. The results obtained in this study point to inappropriate use in CSF of VDRL and FTA-ABS to exclude neurosyphilis in our hospital since only 3.6% of the CSF studied corresponded to patients diagnosed as suffering from neurosyphilis and also to the need for improving the criteria for patient selection.
在五年期间，对萨拉曼卡临床医院就诊患者的194份脑脊液样本进行了针对性病研究实验室玻片试验（VDRL）和荧光密螺旋体抗体吸收试验（FTA - ABS）的反应性研究。该实验室被要求排除梅毒病因。12份脑脊液样本经证实对VDRL和/或FTA - ABS呈反应性（6.2%）。其中7份样本对应的是6名被诊断为患有神经梅毒的成年人以及1名患有早期先天性梅毒但无神经病变的婴儿；这些患者的共同特征是存在活动性梅毒且血清FTA - ABS呈反应性。在6例神经梅毒患者的脑脊液中，2例患者（33.3%）的VDRL呈反应性，5例患者（83.3%）的FTA - ABS呈反应性。在其余5名患者中检测到1例VDRL呈最低限度反应性以及4例FTA - ABS呈反应性，这些患者既往无梅毒病史，患有不同的神经病变且血清FTA - ABS呈非反应性。本研究获得的结果表明，在我院脑脊液中使用VDRL和FTA - ABS来排除神经梅毒并不恰当，因为所研究的脑脊液样本中仅有3.6%对应的是被诊断为患有神经梅毒的患者，这也表明需要改进患者选择标准。
