476例疑似先天性梅毒新生儿血清学转归及影响因素分析

Serological Analysis of 476 Newborns with Suspected Congenital Syphilis and Its Influencing Factors

目的探讨疑似先天性梅毒新生儿血清学转归的影响因素。方法归纳分析10年来该区476例疑似先天性梅毒新生儿的治疗及梅毒血清学结果随访,并进行统计学分析。结果19S-IgM的检测对于确诊先天性梅毒有较高的敏感性(94.44%)及特异性(100.00%)。19S-IgM阴性的疑似先天性梅毒新生儿中,母亲血清学滴度<1∶8者、血清学滴度低于母亲血清学滴度4倍者预后良好,预防性治疗临床意义有限。结论19S-IgM在早期先天性梅毒的诊断中具有重要临床意义,疑似先天性梅毒新生儿仅有相应异常的患儿可应用预防性治疗。临床应加强对疑似先天性梅毒新生儿的随访和复查,及时早期发现先天性梅毒。

Objective To investigate the influencing factors of serological outcomes in 476 newborns with suspected congenital syphilis. Methods The treatment and syphilis serological results of 476 newborns with suspected congenital syphilis in the district in the past ten years were analyzed retrospectively. The results were statistically analyzed. Results The detection of 19S-IgM was highly sensitive （ 94. 44% ） and specific （ 100. 00% ） for the diagnosis of congenital syphilis. The 19S-IgM negative suspected congenital syphilis newborn, whose mother serum titer was lower than 1 ：8, and whose serological titer was lower than the mother serum titer 4 times had good prognosis, but the clinical significance of prophylactic therapy was limited. Conclusion 19S-IgM has important clinical significance in the diagnosis of early congenital syphilis, and the prophylactic treatment can be applied to the newborns with only suspected congenital syphilis. The follow-up and review of the newborns with suspected congenital syphilis should be strengthened so as to discover the congenital syphilis in time.