105例先天性梅毒患儿的临床分析

目的:探讨先天性梅毒的流行情况、临床特点、诊断治疗及预防。方法:收集重庆医科大学附属儿童医院1999～2008年确诊的先天性梅毒患儿105例,对其临床资料进行回顾性分析。结果:①105例病例中,早期先天性梅毒104例,晚期先天性梅毒1例。新生儿57例(54.3%),3月95例(90.5%);②常见临床表现为肝脏肿大、皮肤损害、肺部受累、骨骼受累及黄疸,其例数分别为84例(80%)、67例(63.8%)、66例(62.9%)、38例(36.2%)、38例(36.2%);③105例患儿梅毒抗体检测(RPR)阳性率100%,TPPA阳性率100%(83/83),TRUST检查阳性率90.3%(56/62),75例(71.4%)肝功能受损,53例(50.5%)血液系统受累;④转归:临床症状、体征完全消失50例,临床症状、体征好转36例,临床症状、体征无好转或因各种原因放弃治疗13例。结论:先天性梅毒发病率在近10年(1999～2008)呈逐年上升趋势,多为早期患者,临床表现多样,以肝肿大、皮肤损害、血液系统及骨骼系统受累为主要表现,青霉素仍是有效的治疗药物。

One hundred and five cases clinical analysis of congenital syphilis

Objective:To investigate the prevalence,clinical characteristics,diagnosis,treatment and prevention of congenital syphilis.Methods:105 children with confirmed of congenital syphilis were collected in Children's Hospital of Chongqing Medical University from 1999 to 2008,and the clinical data of them were studied retrospectively.Results:①Among 105 cases,104 cases of early congenital syphilis,one cases of late congenital syphilis.Accounted for 57 cases of newborns (54.3%),< 3 months accounted for 95 cases (90.5%) ;②The common clinical manifestations were liver enlargement,skin lesions,lung involvement,bone involvement,and jaundice,the cases (proportion) were 84 cases (80%),67 cases (63.8%),66 cases (62.9%),38 cases (36.2%) and 38 cases (36.2%) ;③ The positive rate of syphilis antibody test (RPR) in the 105 children was 100%,the TPPA positive rate was 100% (83 /83),the TRUST positive rate was 90.3% (56 /62).75 cases (71.4%) impaired liver function,53 cases (50.5%) involved blood system;④Turnover:clinical symptoms and signs were completely disappeared in 50 cases,clinical symptoms and signs were improved in 36 cases,clinical symptoms and signs were unimproved or for various reasons to give up the treatment of 13 cases.Conclusion:The incidence of congenital syphilis in the past 10 years (1999 ～ 2008) showed an upward trend year by year,most of the early patients,clinical manifestations and diverse to hepatomegaly,skin lesions,blood system and the skeletal system involvement as the main performance,penicillin is still an effective treatment.