先天性风疹感染25例临床分析

目的探讨先天性风疹感染(CRI)的临床特征和预后。方法对2008年9月至2010年9月本科收治的新生儿CRI患儿临床资料进行回顾性分析,总结其临床特征、实验室检查及预后。结果 25例CRI患儿中小于胎龄儿17例,心脏异常4例,眼部异常3例,24 h内出现黄疸4例。24例出生后血液风疹病毒特异性IgM抗体阳性;1例孕34周胎儿脐血风疹病毒IgM及IgG抗体均阳性,生后IgM抗体转阴,IgG抗体阳性;所有孕母孕早期血液风疹病毒特异性IgM抗体均阴性。1例失访,其余24例预后良好,现8个月至2.5岁,神经系统发育均正常,1例男婴体格发育较差。结论 CRI患儿易出现体格发育受限,并伴有不同程度的器官畸形及组织受损,故母孕期应监测风疹病毒抗体,新生儿如有相关临床表现,应尽早检测风疹病毒抗体,及时诊治。

Congenital rubella-analysis of 25 cases

Objective To study the clinical features and prognosis of patients with congenital rubella.Methods Retrospective case analysis was performed on clinical features,laboratory findings and prognosis of 25 CR newborns admitted to our hospital from Sept.2008 to Sept.2010.Results Clinical features have reviewed that 17 neonates were small for gestational age,four had jaundice developed within 24 hours post delivery,four had cardiac defects and three had ocular anomalies.Serology tests have shown that 24/25 neonates were tested RV-IgM positive shortly after birth with one exception: At 34 weeks gestation,the fetus was tested positive for both RV-IgM &-IgG from fetal cord blood;however,by the time of delivery at 35 weeks gestation,his RV-IgM has converted to negative.Interestingly,all the gravidas were tested negative for RV-IgM during early pregnancy,which supports that these pregnant mother’s rubella infection occurred during the mid-or late pregnancy period.24/25 patients whose currently 8-30 months old were available for follow up.Among them,besides one child had moderate to severe growth delay in weight and height;the other 23 patients have demonstrated normal physical growth parameters.All children had normal neurological development,and had passed hearing screening.Conclusions Rubella infection leads to fetal growth retardation and multiple organ abnormalities.Therefore,RV specific antibody screening is not only necessary during pregnancy,but also during neonatal period,if a child has the clinical features of CRI.