梅毒孕妇及其患儿的临床表现与梅毒抗体的分析研究

Clinical manifestations of syphilis pregnants and congenital syphilis infants and analysis of treponemal antibody.

目的了解梅毒孕妇及其先天梅毒患儿的临床特点及血清、脑脊液梅毒抗体的检测情况。方法对40例梅毒孕妇及其所产婴儿进行了临床特点和血清、脑脊液梅毒抗体的分析。结果40例梅毒孕妇中,潜伏梅毒占87.5%,TPPA检测均阳性,RPR阳性的有35例,滴度介于1:1-1:128之间;40例先天梅毒患几中出现皮疹的有14例(35%),有骨损害表现的6例(15%),由于母亲患梅毒而就诊的16例(40%),RPR检测阳性33例(82.5%),滴度介于1:1-1:64之间,2例RPR异常增高,滴度为1:128。脑脊液常规检查显示,45%患儿淋巴细胞增高,50%蛋白增多,22.5%梅毒抗体检测阳性。结论应重视妊娠期梅毒筛查,对于确诊的先天梅毒患儿,注意无症状神经梅毒的发生,为正确评价病情和治疗有重大意义。

Objective To understand the clinical features of pregnants and their infants with congenital syphilis and the detection of antibody against congenital syphilis in the serum and cerebrospinal fluid. Methods The clinical features and detection results of antibodies against syphilis in the 40 pregnant women and infants with congenital syphilis were analyzed. Results 87.5% od the pregnant women infected with were latent syphilis and all of them were positive by TPPA and 35 of them were positive by RPR with the titres between 1 ： 1 and 1 ： 128. rashes occurred to 14 infants （35%）, bone damage occurred to 6 cases （ 15% ） ; 16（40% ） infants who＇ s mothers were syphilis patients. 33 infants were positive by RPR with a titres of between 1 ： 1 and 64; the abnormal titre of 1 ： 128 by RPR was observed in 2 cases. The conventional determination of cerebrospinal fluid of infants demonstrated that lymphocyte elevated in 18（45% ） cases; elevated protein concentration was observed in 20（50% ）cases and treponemal antibody was detected from CSF of 9（22.5% ） cases. Conclusion Attention be paid to the screening of syphilis patients in gestational period and the occurence of asymptomatic neurosyphilis in infants with congenital syphilis. The detection of treponemal antibody in CSF of infants with congenital syphilis is helpful for evaluation of the pathogenic condition and correct treatment of the patients.