库车地区早期胎传梅毒42例临床特征分析

Clinical features analysis of 42 cases of early fetal syphilis in Kuqa area

目的探讨库车地区早期胎传梅毒的临床特征,提高对早期胎传梅毒的诊治水平。方法收集2019年1月至2020年12月库车市人民医院新生儿科收治并确诊的42例早期胎传梅毒患儿的病历资料,回顾性分析42例患儿的临床表现、实验室检查结果、影像学资料及治疗情况。结果42例患儿中男性23例(54.76%),女性19例(45.24%)。37例(88.10%)来自农村地区,40例(95.24%)为维吾尔族。临床特征发生率较高的有心肌酶增高(66.67%)、黄疸(64.29%)、贫血(61.90%)、转氨酶升高(59.52%)、皮疹(45.24%)、肝脾肿大(40.48%)等非特异性表现。母亲治疗组与母亲未治疗组在早产、低出生体重、黄疸、皮疹、肝脾肿大、贫血、血小板减少及转氨酶升高临床特征方面差异有统计学意义(P<0.05)。42例患儿RPR及TPPA均阳性。RPR滴度位于1∶4~1∶256之间。42例患儿均给予注射用青霉素钠治疗,无不良反应发生。结论早期胎传梅毒患儿临床特征多种多样,缺乏特异性,早期诊断应结合血清学指标,梅毒母亲产前规范治疗能有效改善分娩结局。

Objective To explore the clinical features of early congenital syphilis in the Kuqa area,to improve the diagnosis and treatment of early fetal syphilis.Methods We collected the information from medical records of 42 cases with early congenital syphilis treated at the Department of Neonatology of Kuqa People's Hospital from January 2019 to December 2020.A retrospective analysis was performed on clinical manifestations,laboratory test results,imaging data,and treatment outcomes.Results Among the 42 children in our study,23 were male(54.76%),and 19 were female(45.24%).37(88.10%)came from rural areas,and 40(95.24%)were Uyghur.The frequent clinical features observed were elevated myocardial enzyme(66.67%),jaundice(64.29%),anemia(61.90%),elevated transaminase(59.52%),rash(45.24%),hepatosplenomegaly(40.48%),and other non-specific manifestations.There were significant differences in premature delivery,low birth weight,jaundice,rash,hepatosplenomegaly,anemia,thrombocytopenia,and elevated transaminase between the maternal treatment group and the maternal untreated group(P<0.05).The RPR and TPPA were positive in all 42 children.The RPR titer ranged from 1∶4 to 1∶256.42 children were treated with penicillin sodium injection.No adverse reactions occurred.Conclusions The clinical manifestations of early congenital syphilis are diverse and lack specificity.Early diagnosis should be combined with serological indicators.Prenatal maternal treatment can effectively improve delivery outcomes.