中文摘要：

目的通过分析麻痹性痴呆（generalparesisoftheinsane，GPI）患者的临床表现、及实验室检查（包括大脑影像学、脑电图）特征，提高GPI早期诊断准确率。方法回顾性分析2003—08—2011-11收治的12例GPI患者临床表现、实验室检查（包括影像学及脑电图）结果、诊断及治疗转归。结果本组12例GPI（男10例、女2例）中，表现为认知损害12例，腱反射亢进10例；血清快速血浆反应素试验（serumrapidplasmareactiontest，RPR）阳性11例，梅毒螺旋明胶体被动颗粒凝集试验（serumtreponemapalladiumparticleagglutination，TPPA）阳性7例，荧光密螺旋抗体吸收试验（fluorescenttreponemalantibodyabsorption，FTA—ABS）阳性4例；脑脊液白细胞计数增高6例，蛋白质增高9例，其中5例为脑脊液白细胞及蛋白质同时增高；8例行脑脊液RPR均为阳性，12例行梅毒螺旋体血凝试验测定（treponemapaltidumhemagglutinationassay，TPHA）均为阳性；头部CT、MRI改变以颞叶海马部脑萎缩、脑梗死为主；脑电图以轻度异常改变为主。误诊8例。所有患者经青霉素驱梅治疗后临床症状都有不同程度好转，3例患者复查血清RPR滴度下降。结论GPI临床表现复杂多变，误诊率高，应结合实验室及影像学检查综合分析，早期诊断及治疗极为重要。

英文摘要：

Objective To analyze the clinical characteristics and improve the diagnosis of general paresis of the insane （GPI）. Methods Retrospectively analyzed the clinical manifestation, laboratory examinations, neuroimaging examinations, diagnosis and treatment outcomes of 12 patients with GPI who were hospitalized in the First Affiliated Hospital, Guangxi Medical University, from early August 2003 to November 2011. Results Cognitive impairment （memory, calculation, understanding, and orientation） was the principal symptom in 12 cases. The most common sign was brisk tendon reflex in 9 cases. Serum rapid plasma reaction test （RPR） was positive in 11 cases, and serum treponema palladium particle agglutination （TPPA） was positive in 7 cases, fluorescent treponemal antibodyabsorption （FTA-ABC） was positive in only 4 cases. Cerebrospinal fluid （CSF） protein was increased in 9 cases and cell counts were elevated in 6 cases, both were increased in 5 cases. CSF- RPR was positive in 8 cases. CSF treponema pallidum hemagglutination assay （TPHA） was positive in all the patients. Cerebral atrophy in frontotemporal and hippocampus regions detected with MRI/CT was common. Electroencepha｜ graphy （EEG） showed abnormal activity in most of the cases. Eight cases had been misdiagnosed. All the patients were treated with a large dose of penicillin and clinical symptoms were improved markedly. The titer of serum RPR decreased in 3 cases tested. Conclusions The clinical manifestation of GPI are varied and is misdiagnosis rate high. The diagnosis of GPI needs laboratory and neuroimaging examinations. Early diagnosis and treatment of GPI is important.