Zhang Rui-Li, Zhang Xu, Du Fang-Zhi, Zhou Qian-Yang, Wu Min-Zhi, Ren Jian-Jun, Zhou Zhe, Li Ai-Li, Li Dong-Dong, Li Hong-Xia, Yang Li-Gang, Feng Wen-Li, Yang Tian-Ci, Li Yu-Ye, Zhang Jie, Wang Su-Ping, Luo Yang, Gu Ming-Sheng, Yu Xiao-Yun, Hu Li-Hua, Zhao Jian-Bin, Ma Yin-Ni, Ma Xiao-Wen, Zeng Tong-Xiang, Gao Ying, Wang Qian-Qiu
Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Institute of Dermatology, Peking Union Medical College, Chinese Academy of Medical Sciences, National Center for STD Control, Centers for Disease Control and Prevention, Nanjing, China.
Sci Rep. 2024 Dec 28;14(1):31171. doi: 10.1038/s41598-024-82477-6.
Diagnosing neurosyphilis in clinical settings poses significant challenges due to the absence of highly efficient diagnostic criteria. Our objective was to enhance the existing diagnostic criteria and assess their sensitivity and specificity for identifying neurosyphilis in HIV-negative patients. We conducted a retrospective review of patient records from a cross-sectional study carried out between December 2019 and May 2023. This study was designed to explore clinical practices in the diagnosis and treatment of neurosyphilis. We proposed and validated a new set of diagnostic criteria across 782 cases, comparing three different NS criteria for diagnostic efficiency. Among the 782 patients analyzed, 410 were diagnosed with neurosyphilis, while 372 were not. The newly developed NS criteria demonstrated a sensitivity of 99.5% and a specificity of 94.6%, with the added benefit of being user-friendly. In subgroups categorized by neurological symptoms and syphilis stages, the new NS criteria also exhibited high sensitivity and specificity. Statistical analyses confirmed that the novel NS criteria performed comparably well to the expanded NS criteria. The novel NS criteria for HIV-negative patients exhibited high sensitivity and specificity, proving to be both effective and convenient for physicians to implement.
由于缺乏高效的诊断标准，在临床环境中诊断神经梅毒面临重大挑战。我们的目标是完善现有诊断标准，并评估其在识别HIV阴性患者神经梅毒方面的敏感性和特异性。我们对2019年12月至2023年5月期间开展的一项横断面研究中的患者记录进行了回顾性分析。该研究旨在探索神经梅毒的诊断和治疗临床实践。我们提出并验证了一套涵盖782例病例的新诊断标准，比较了三种不同的神经梅毒诊断标准的诊断效率。在分析的782例患者中，410例被诊断为神经梅毒，372例未被诊断为神经梅毒。新制定的神经梅毒诊断标准敏感性为99.5%，特异性为94.6%，且具有用户友好的额外优势。在按神经症状和梅毒分期分类的亚组中，新的神经梅毒诊断标准也表现出高敏感性和特异性。统计分析证实，新的诊断标准与扩展的诊断标准表现相当。针对HIV阴性患者的新诊断标准具有高敏感性和特异性，对医生而言既有效又便于实施。
