新生儿先天性神经梅毒的临床特征分析及随访研究

Clinical Features and Following-up of Congenital Neurosyphilis in Newborns

目的探讨新生儿先天性神经梅毒的临床特征,经青霉素治疗后随访患儿治疗效果。方法随机选择45例先天性神经梅毒新生儿作为研究组,选择同期来我院健康体检婴儿40例作为对照组。回顾性分析研究组患儿的主要临床症状及特征,所有患儿均采用青霉素治疗,合并其他疾病者给予对症治疗。对两组婴儿进行为期2年的系统随访,采用快速血浆反应素试验(RPR)评估治疗效果,对比两组婴儿身高、体重、神经心理发育情况。结果研究组患儿随访6个月RPR转阴率为62.2%,12个月转阴率为88.9%,24个月转阴率为95.6%。研究组患儿的身高、体重、DQ值均明显低于对照组,差异具有统计学意义(P<0.05)。结论新生儿先天性神经梅毒临床症状复杂多样,无显著特异性,医生临床诊断时需要提高警惕。经治疗后,随着年龄的增加,患儿RPR转阴率逐渐提高,但是患儿的生长发育及神经心理发育受影响。

Objective To investigate the clinical characteristics of congenital neurosyphilis in newborns, and study the effect atter peniciUin treatment. Methods 45 newborns with congenital syphilis were randomly set as study group, 40 healthy newborns received physical examination in our hospital were set as control group. The main clinical symptoms and characteristics of newborns in study group were retrospectively analyzed. In study group, all newborns were treated with penicillin, and newborns with other complications were given Symptomatic treatment. Both groups were followed up for two years. The treatment effect was evaluated by rapid plasma test （RPR）, the newborns＇ height, weight, the development of nerve and mentality were compared. Results In experimental group, the RPR negative rate of newborns after following up for six months, twelve months and twenty-four months were 62.2%, 88.9%, 95.6% respectively. The newborns＇ height, weight and DQ value in study group were lower than those in control group （P 〈0.05）. Conclusions The clinical features of congenital syphilis in newborns are complicated and diverse, without significant specificity, and clinical diagnosis should be made warily. After treatment, the RPR negative rate increases gradually with age, but newborns＇ development of growth and neuropsychology are affected.