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[大剂量静脉注射青霉素治疗神经梅毒:62例研究。II. 脑脊液评估]

[High-dose intravenous penicillin therapy in neurosyphilis: study of 62 cases. II. Evaluation of cerebrospinal fluid].

作者信息

Nitrini R, Spina-França A

机构信息

Clínica Neurológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.

出版信息

Arq Neuropsiquiatr. 1987 Sep;45(3):231-41. doi: 10.1590/s0004-282x1987000300003.

Abstract

Sixty-two patients with symptomatic neurosyphilis were treated with 20 or 24 megaunits of intravenous penicillin G daily for 15 to 30 days. The mean follow-up time after the treatment was 30 months. Forty-one patients had pleocytosis in the CSF before treatment. Six months and twelve or more months later, abnormal cell count was observed in 4 (9.8%) and in 3 patients (7.3%), respectively. The CSF protein level and the titers of Wassermann reaction in the CSF decreased slowly after treatment. The gammaglobulin concentration of the CSF and the immunoglobulin production inside the blood-brain barrier were still increased beyond the first year after treatment. The results of the treatment of these patients with high doses of intravenous penicillin G were not different from the results verified with lesser doses of intramuscular penicillin that were reported in the literature.

摘要

62例有症状的神经梅毒患者接受了每日20或24万单位静脉注射青霉素G治疗,疗程为15至30天。治疗后的平均随访时间为30个月。41例患者在治疗前脑脊液中有细胞增多现象。6个月及12个月或更长时间后,分别有4例(9.8%)和3例(7.3%)患者观察到异常细胞计数。治疗后脑脊液蛋白水平和脑脊液瓦氏反应滴度缓慢下降。脑脊液γ球蛋白浓度和血脑屏障内的免疫球蛋白产生在治疗后第一年仍持续升高。这些患者使用大剂量静脉注射青霉素G的治疗结果与文献报道的使用较小剂量肌肉注射青霉素的验证结果并无差异。

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