中华皮肤科杂志 ›› 2026, Vol. 59 ›› Issue (10): 947-952.doi: 10.35541/cjd.20260312

• 论著·性传播疾病 • 上一篇    下一篇

神经梅毒临床路径的临床应用研究

郑晓丽1    吴敏智2    杜方智1    龙福泉3    周哲4    杨立刚5    陈韡6    李爱莉7    蒋法兴8    金首跃9    高英10    赵建斌11    任旭琦12    李世慎13    王艳14    冯素英15    谢碧波16    张瑞丽17    王千秋18   

  1. 1中国医学科学院北京协和医学院，皮肤病医院  中国疾病预防控制中心性病控制中心临床防治室，南京  210042；2苏州市第五人民医院皮肤科，苏州  215131；‌3上海市皮肤病医院性病科，上海  200003；4西安市北方医院皮肤科，西安  710032；5南方医科大学皮肤病医院皮肤科，广州  510091；‌6南京市第二医院皮肤科，南京  ‌210003；7大连市皮肤病医院性病科，大连  116000；8安徽省立医院皮肤科，合肥  234000；9厦门大学附属中山医院神经内科，厦门  361000；10武汉市中心医院皮肤科，武汉  430014；11徐州市第一人民医院皮肤科，徐州  221002；‌12南通大学附属医院皮肤科，南通  226007；13广西壮族自治区皮肤病医院性病科，南宁  530007；‌14山西医科大学第二医院皮肤科，太原  030001；15中国医学科学院北京协和医学院，皮肤病医院性病科，南京  210042；16浙江省皮肤病医院皮肤科，湖州  313299 ；17南京医科大学第二附属医院皮肤科，南京  210011；18中国医学科学院北京协和医学院，皮肤病医院  中国疾病预防控制中心性病控制中心  中心办公室，南京  210042
    郑晓丽和吴敏智对本文有同等贡献

  • 收稿日期:2026-06-02 修回日期:2026-09-02 发布日期:2026-10-07
  • 通讯作者: 王千秋；张瑞丽；杜方智 E-mail:wangqq@ncstdlc.org; reallyvictor@126.com; dufangzhi_090724@163.com
  • 基金资助:
    中国医学科学院医学与健康科技创新工程项目（2021-I2M-1-001）；江苏省医学重点实验室、江苏省科教能力提升工程项目（ZDXYS202204）；江苏省“双创博士”人才项目 （JSSCBS20221929）

Clinical application of the clinical pathway for neurosyphilis: a pilot study

Zheng Xiaoli1, Wu Minzhi2, Du Fangzhi1, Long Fuquan3, Zhou Zhe4, Yang Ligang5, Chen Wei6, Li Aili7, Jiang Faxing8, Jin Shouyue9, Gao Ying10, Zhao Jianbin11, Ren Xuqi12, Li Shishen13, Wang Yan14, Feng Suying15, Xie Bibo16, Zhang Ruili17, Wang Qianqiu18   

  1. 1Department of STD Clinical Management and Intervention, National Center for STD Control, Chinese Center for Disease Control and Prevention, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China; 2Department of Dermatology, the Fifth People's Hospital of Suzhou, Suzhou 215131, China; 3Department of Sexually Transmitted Diseases, Shanghai Skin Disease Hospital, Shanghai 200003, China; 4Department of Dermatology, Xi′an North Hospital, Xi′an 710032, China; 5Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou 510091, China; 6Department of Dermatology, the Second Hospital of Nanjing, Nanjing 210003, China; 7Department of Sexually Transmitted Diseases, Dalian Dermatosis Hospital, Dalian 116000, China; 8Department of Dermatology, Anhui Provincial Hospital, Hefei 234000, China; 9Department of Neurology, Zhongshan Hospital, Xiamen University, Xiamen 361000, China; 10Department of Dermatology, the Central Hospital of Wuhan, Wuhan 430014, China; 11Department of Dermatology, Xuzhou No.1 People′s Hospital, Xuzhou 221002, China; 12Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226007, China; 13Department of Sexually Transmitted Diseases, Dermatology Hospital of Guangxi Zhuang Autonomous Region, Nanning 530007, China; 14Department of Dermatology, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China; 15Department of Sexually Transmitted Disease, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China; 16Department of Dermatology, Zhejiang Provincial Dermatology Hospital, Huzhou 313299, China; 17Department of Dermatology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China; 18STD Center Office, National Center for STD Control, Chinese Center for Disease Control and Prevention, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
    Zheng Xiaoli and Wu Minzhi contributed equally to the article
  • Received:2026-06-02 Revised:2026-09-02 Published:2026-10-07
  • Contact: Wang Qianqiu; Zhang Ruili; Du Fangzhi E-mail:wangqq@ncstdlc.org; reallyvictor@126.com; dufangzhi_090724@163.com
  • Supported by:
    CAMS Innovation Fund for Medical Sciences （2021-I2M-1-001）; Jiangsu Provincial Medical Key Laboratory, Jiangsu Province Capability Improvement Project through Science, Technology and Education （ZDXYS202204）; Jiangsu Provincial Double Innovation Doctor Program （JSSCBS20221929）

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摘要： 【摘要】 目的 报告《神经梅毒临床路径（试行）》的临床应用情况。方法 本研究为前瞻性、多中心、非对照的实施性研究。2025年1月至2026年3月期间，于16家中国神经梅毒临床监测哨点/中国“一带一路”皮肤病学专科联盟-神经梅毒研究联盟单位试运行《神经梅毒临床路径（试行）》，采集神经梅毒患者的路径运行效果数据。结果 研究期间共筛查1 703例入院疑诊神经梅毒患者，确诊神经梅毒485例（28.48%）。确诊患者中，无症状神经梅毒占比最高（241/485例，49.69%），有症状神经梅毒中以麻痹性痴呆（95/485例，19.59%）和脊髓痨（59/485例，12.16%）为主。485例确诊患者中438例进入临床路径，入径率90.31%，其中脊髓痨（59/59）和脑脊膜型（17/17）入径率为100%，无症状神经梅毒和其他类型入径率相对较低，分别为87.97%（212/241例）和87.50%（7/8例）。438例入径患者中430例完成路径，完成率98.17%，脊髓痨（59/59例）和其他类型（7/7例）完成率达100%，麻痹性痴呆（80/85例）和脑脊膜型（16/17例）完成率相对较低，均为94.12%。整体变异例数29例（6.62%），其他类型神经梅毒变异率最高（1/7例，14.29%），其次为无症状神经梅毒（17/212例，8.02%）。37例（8.45%）接受多学科诊疗会诊，会诊科室主要涉及神经内科、精神科等，多针对合并复杂症状的病例。结论 《神经梅毒临床路径（试行）》整体运行良好，可进一步推广。

关键词: 神经梅毒, 临床路径, 临床应用, 入径率, 完成率, 变异率

Abstract: 【Abstract】 Objective To evaluate the clinical application performance of the Clinical Pathway for Neurosyphilis（Trial Version）. Methods This was a prospective, multicenter, uncontrolled implementation study. From January 2025 to March 2026, the Clinical Pathway for Neurosyphilis（Trial Version） was piloted at 16 Chinese neurosyphilis clinical surveillance sentinel sites/member institutions of the Neurosyphilis Research Alliance, the China "Belt and Road" Dermatology Alliance. Data on the performance of the clinical pathway in patients with neurosyphilis were collected. Results During the study period, a total of 1 703 hospitalized patients with suspected neurosyphilis were screened, and 485 （28.48%） were diagnosed with neurosyphilis. Among the confirmed patients, asymptomatic neurosyphilis was the most common type （241/485, 49.69%）; among the patients with symptomatic neurosyphilis, general paresis （95/485, 19.59%） and tabes dorsalis （59/485, 12.16%） were the most common clinical forms. Of the 485 confirmed patients, 438 were enrolled in the clinical pathway, corresponding to an entry rate of 90.31%; the entry rates for tabes dorsalis （59/59） and meningeal neurosyphilis （17/17） reached 100%, whereas entry rates for asymptomatic neurosyphilis （212/241, 87.97%） and other types （7/8, 87.50%） were relatively low. Of the 438 enrolled patients, 430 completed the pathway, with a completion rate of 98.17%; the completion rates for tabes dorsalis （59/59） and other types （7/7） reached 100%, whereas those for general paresis （80/85, 94.12%） and meningeal neurosyphilis （16/17, 94.12%） were relatively low. The overall variation rate was 6.62% （29/438）, with the highest variation rate observed in other types of neurosyphilis （1/7, 14.29%）, followed by asymptomatic neurosyphilis （17/212, 8.02%）. Thirty-seven patients （8.45%） received multidisciplinary consultations, primarily by specialists in neurology and psychiatry for complex comorbidities. Conclusion The Clinical Pathway for Neurosyphilis（Trial Version）generally performed well and can be further promoted.

Key words: Neurosyphilis, Clinical pathway, Clinical application, Entry rate, Completion rate, Variation rate

引用本文

郑晓丽 吴敏智 杜方智 龙福泉 周哲 杨立刚 陈韡 李爱莉 蒋法兴 金首跃 高英 赵建斌 任旭琦 李世慎 王艳 冯素英 谢碧波 张瑞丽 王千秋. 神经梅毒临床路径的临床应用研究[J]. 中华皮肤科杂志, 2026,59(10):947-952. doi:10.35541/cjd.20260312

Zheng Xiaoli, Wu Minzhi, Du Fangzhi, Long Fuquan, Zhou Zhe, Yang Ligang, Chen Wei, Li Aili, Jiang Faxing, Jin Shouyue, Gao Ying, Zhao Jianbin, Ren Xuqi, Li Shishen, Wang Yan, Feng Suying, Xie Bibo, Zhang Ruili, Wang Qianqiu. Clinical application of the clinical pathway for neurosyphilis: a pilot study[J]. Chinese Journal of Dermatology, 2026, 59(10): 947-952.doi:10.35541/cjd.20260312