新生儿先天性梅毒36例临床分析

Clinical analysis of 36 neonates with congenital syphilis

目的探讨新生儿先天性梅毒的临床特点及该病与其母妊娠期间治疗情况的关系。方法对36例出生后确诊为先天性梅毒患儿进行临床资料分析,将其母妊娠期分为正规治疗组(A组)和未治疗或治疗不彻底组(B组),对比两组患儿的临床特征。结果先天性梅毒的临床表现多样,A组先天性梅毒患儿出生时出现临床症状的例数低于B组,B组间接胆红素在出生时和出生后14d较A组高,丙氨酸氨基转移酶(ALT)水平两组在出生时差异无统计学意义,出生后14dB组较A组升高。结论先天性梅毒的诊断应根据临床表现及血清学检查结果等综合分析,其母在孕期未治疗或治疗不彻底的先天性梅毒患儿出生后临床表现较重,且肝功能受损情况也相对较重。积极开展婚前及孕期梅毒筛查,早期诊断、早期正规治疗是减少梅毒对患儿损害的关键。

Objective To investigate the clinical features of neonate with congenital syphilis and the relationship between the incidence of congenital syphilis and the mother′s treatment during pregnancy.Methods To analyse the clinical data of 36 newborns diagnosed congenital syphilis,and according to the regular treatment and non-treatment or inadequate treatment during pregnancy,their mothers were divided into A and B groups.Finally to compare the clinical characteristics of two groups.Results The clinical manifestations of congenital syphilis varied.The incidence of the clinical symptoms in A group was less than that of B group.The amounts of indirect bilirubin in B group at birth day and on postnatal 14d was higher than those in A group.The level of ALT between two groups had no significant difference at birth day.On 14d of birth,B group′s was more than A group′s.Conclusion The clinical manifestations and serological examination should be used to the diagnosis of congenital syphilis.If the mother during pregnancy without treatment or inadequate treatment,the clinical symptom of her children is worse,and the liver damage of the newborn is also relatively worse.Before marriage and during pregnancy,active work on syphilis screening should be carried out,and early diagnosis and regular treatment are the key to reduce the damage of children with syphilis.