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[脑脊液中梅毒血清学试验(VDRL)和荧光密螺旋体抗体吸收试验(FTA-ABS)的反应性:我们的经验]

[VDRL and FTA-ABS reactivity in cerebrospinal fluid: our experience].

作者信息

García-Rodríguez J A, Martín-Sánchez A M, Canut A, García-García L, Cacho J

机构信息

Servicio de Neurología, Hospital Clínico Universitario, Salamanca.

出版信息

Enferm Infecc Microbiol Clin. 1990 Jan;8(1):43-7.

PMID:2095904
Abstract

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.

摘要

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。

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