Tang Yijie, Yang Dandan, Zhang Jiaqin, Shen Lingyun, Xie Qinghui, Luo Qingqiong
Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China.
Eur J Med Res. 2024 Dec 18;29(1):591. doi: 10.1186/s40001-024-02195-7.
Neurosyphilis (NS) is the most serious complication elicited by the invasion of Treponema pallidum (T. pallidum) into the central nervous system. Identifying the neuro-invasion of T. pallidum as early as possible is important. Looking for indicators with good performance and convenient to operate is in great demand for the diagnosis of NS.
A cross-sectional study was conducted on 428 human immunodeficiency virus (HIV)-negative syphilis patients who underwent therapy in Shanghai Skin Disease Hospital from April 2022 to June 2023. The syphilis patients were further grouped into non-neurosyphilis (NNS), asymptomatic neurosyphilis (ANS) and symptomatic syphilis (SNS). Laboratory examination results of these patients were analyzed.
Significantly elevated neutrophil CD64 (nCD64) index and neutrophil to lymphocyte ratio (NLR) were observed in ANS and SNS patients compared with those of NNS patients. nCD64 index and NLR were strongly correlated with serum and cerebrospinal fluid (CSF) TRUST titer, CSF WBC and CSF protein levels in NS patients. nCD64 index and NLR were independent factors influencing NS, especially ANS. Logistic regression models based on nCD64 index, NLR and serum TRUST titer exhibited better diagnostic performances to the currently used markers in NS diagnosis. Particularly, for NS patients with negative CSF TRUST, diagnostic performance of the combined nCD64 and NLR was obviously superior to CSF protein and CSF WBC.
Neutrophil-related indicators-nCD64 index and NLR have potential application value in the diagnosis of NS, especially for the CSF TRUST negative patients.
神经梅毒（NS）是梅毒螺旋体侵入中枢神经系统引起的最严重并发症。尽早识别梅毒螺旋体的神经侵袭至关重要。寻找性能良好且操作便捷的指标对神经梅毒的诊断有迫切需求。
对2022年4月至2023年6月在上海市皮肤病医院接受治疗的428例人类免疫缺陷病毒（HIV）阴性梅毒患者进行横断面研究。将梅毒患者进一步分为非神经梅毒（NNS）、无症状神经梅毒（ANS）和有症状梅毒（SNS）。分析这些患者的实验室检查结果。
与NNS患者相比，ANS和SNS患者的中性粒细胞CD64（nCD64）指数和中性粒细胞与淋巴细胞比值（NLR）显著升高。nCD64指数和NLR与神经梅毒患者的血清和脑脊液（CSF）TRUST滴度、CSF白细胞和CSF蛋白水平密切相关。nCD64指数和NLR是影响神经梅毒尤其是无症状神经梅毒的独立因素。基于nCD64指数、NLR和血清TRUST滴度的逻辑回归模型在神经梅毒诊断中对目前使用的标志物表现出更好的诊断性能。特别是，对于CSF TRUST阴性的神经梅毒患者，联合nCD64和NLR的诊断性能明显优于CSF蛋白和CSF白细胞。
中性粒细胞相关指标——nCD64指数和NLR在神经梅毒诊断中具有潜在应用价值，尤其是对于CSF TRUST阴性患者。
