107例先天梅毒临床流行病学研究

目的先天梅毒(congenital syphilis,CS)近年在中国呈快速上升趋势,本文通过研究先天梅毒临床流行病学,旨在分析当前先天梅毒诊疗中存在的问题。方法对1999年2月至2003年2月间复旦大学附属儿科医院收治的107例先天梅毒患儿围产期、临床诊疗资料进行分析。结果在先天梅毒患儿母亲中,89.7%为流动人口,30.8%未进行妊娠期梅毒血清学筛查,94.4%未予正规青霉素治疗。先天梅毒新生儿期表现多变,以皮肤黏膜、骨骼损害较为特异,其比例分别为72%、40%。结论先天梅毒的发生多见于流动人口,孕妇缺乏梅毒血清学筛查和正规青霉素治疗是导致先天梅毒发生的最主要因素,政府应该加强对流动人口先天梅毒防治的管理。

Clinical epidemiology of 107 cases with congenital syphilis

Objective Congenital syphilis has recentely become an serious health problem in China.We tried to retrospectively analyze the clinical manifestations,diagnosis,treatment of congenital syphilis,and to understand the problem in diagnosis and therapy associated with congenital syphilis.Methods From Feb 1999 to Feb 2003 at our hospital,107 congenital syphilis neonates were diagnosed,according to the American Centers for Disease Control(CDC)criteria.The medical records were reviewed including the history of pregnancy,clinical manifestation,serologic testing and treatment.Results About 89.7% of the neoates' mothers were migrants who had poor education.About 30.8% of the mothers were lack of prenatal syphilis serologic testing,and 94.4% of the mothers did not treated with appropriate penicillin regimen.Early clinical signs in the infected neonate of congenital syphilis were variable,rash and bone involved were the early clinical specific manifestations.Rash occurred in 72% neonates and osteochondritis affected 40% neonates.Conclusions Congenital syphilis is more oftenly happened in immigrants.Lack of prenatal serologic testing and management of syphilis in immigrant pregnant women resulted in the accidence of congenital syphilis.Emphasis of government policy is adviced on primary prevention of syphilis among immigrant pregnancy women.