先天性梅毒合并巨细胞病毒感染的临床特征

Clinical features of congenital syphilis complicated with CMV infection

目的总结先天性梅毒(CS)合并其他感染的临床特征。方法选择单纯CS患儿75例、CS合并巨细胞病毒(CMV)感染患儿43例,通过血液、尿液、胸部X线检查,分析病例的一般资料、临床特征、肝功能损伤。结果单纯CS患儿住院时间大于7 d的占34%,低于CS合并CMV感染患儿(79.06%);单纯CS患儿父母文化水平高于合并CMV感染患儿;CS患儿父母血RPR阳性率低于合并CMV感染的患儿,差异均有统计学意义(P <0.05)。CS合并CMV感染患儿的肝脾肿大、贫血和胸部X射线异常率均高于单纯CS患儿,差异均有统计学意义(P <0.05)。CS合并CMV感染患儿在肝功能损伤率(90.69%)、肝功能II级异常率(34.88%),均高于单纯CS患儿(53.33%和12%),差异有统计学意义(P <0.05)。Logistic回归分析发现,父母血RPR阳性、肝脾肿大、肝功能II^III级异常是导致CS患儿合并CMV感染的高危因素。结论合并CMV感染的CS患儿肝功能损伤更严重,应早期诊断、早期治疗。

Objective To analyze the clinical features of congenital syphilis children complicated with other infections. Methods The subjects were 75 cases of CS children and 43 cases of CS children complicated with cytomegalovirus(CMV) infection. The blood,urine and chest X-ray were tested. The data of general information,data,clinical features and liver function were all analyzed. Results The percentage of hospitalization time more than 7 days of CS cases was 34%,which was lower than that of CS with CMV infection cases(79.06%). The educational level of parents of CS cases was higher than that of CS with CMV infection cases. The RPR positive rate of parents of CS cases was lower than that of CS with CMV infection cases,and the difference was statistical significant(P < 0.05).The liver and spleen enlargement,anemia and abnormal chest X-ray found in CS with CMV infection children was higher than those of CS cases,with significant differences(P < 0.05). The loss of liver function(90.69%) and abnormal II class(34.88%) in CS with CMV infection cases,which was higher than those of CS cases(53.33% and12%),and the difference was statistical significant(P < 0.05). Logistic regression analysis showed that the parents RPR positive,hepatosplenomegaly,liver function II-III class abnormal were risk factors lead to CS children complicated CMV infection. Conclusion The liver function damage of CS with CMV infection children was more serious,it should to be diagnosed and treatment earlier.