婴儿梅毒38例分析

Analysis of 38 cases of infantile syphilis

目的 :探讨婴儿梅毒的母体情况、婴儿梅毒临床特点、辅助检查及治疗与预后的关系。方法 :对38例婴儿梅毒的临床资料及其母亲孕期情况进行回顾性分析。结果:38例婴儿梅毒中,28例(73.6%)在3个月内发病,临床表现最常见依次为皮疹,贫血,骨骼损害,鼻塞,黄疸等。辅助检查:血常规异常、C反应蛋白增高、肝功能损害等常见,10例(26.3%)四肢长骨X线片提示骨损害。患儿血清快速血浆反应素环状卡片试验滴度≥1∶32者24例(63.1%),母亲孕期予以苄星青霉素正规治疗2例(5.2%)。经水剂青霉素或头孢曲松治疗后,随访26例,均提示治疗有效。结论:婴儿梅毒临床表现多样,诊断需要综合母体孕期、分娩时情况及辅助检查等,经水剂青霉素或头孢曲松治疗后预后好。

Objective： To analyze the maternal conditions, clinical and laboratory features, as well as relationship between treatment and prognosis of infantile syphilis. Methods： Clinical data and maternal conditions were retrospectively analyzed in 38 infant inpatients with syphilis at the Department of Dermatology and Venerology, Fifth People＇s Hospital of Suzhou from 2009 to 2015. Results： Of the 38 patients, 73.6% of patients（28/38） developed syphilis within 3 months of birth. The most common clinical symptom was skin rash, followed by anemia, skeleton damage, nasal congestion and jaundice. Laboratory tests often showed abnormalities in routine blood test, C reactive protein levels, and liver function. X ray showed abnormal long bone of the limbs in 10 patients（26.3%）. 24 patients（63.1%） displayed the titer of serum rapid plasma regain（RPR） test≥1： 32. 2 pregnant mothers were treated with benzathine penicillin. Both penicillin and eeftriaxone were effective for infantile syphilis based on the results of the post-treatment follow-up in 26 patients. Conclusions： Infantile syphilis has diverse clini- cal manifestations. The diagnosis should be made according to maternal conditions and laboratory tests. The prognosis is good after treatment with penicillin or ceftriaxone.