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对母确诊为梅毒的13例新生儿病例进行临床分型、影像学检查、免疫测定和定期随访,探讨母产前梅毒螺旋体治疗情况对新生儿发病的影响,新生儿期先天性梅毒(CS)的主要临床表现。新生儿期确诊为CS共5例,疑诊3例,正常5例;确诊5例中母未治疗4例,产时较治疗前RPR滴度下降<4倍1例,产时RPR滴度>1:4共4例,新生儿RPR滴度≥母4倍3例。CS临床表现以早产、肝脾肿大、皮疹为主。神经系统早期改变主要为脑脊液蛋白增高。13例中失防2例,确诊组和正常组各1例;确诊组1例给予重复治疗,3例RPR滴度不同程度下降;疑诊组RPR滴度均在4个月内阴转;正常组持续阴性。结论:新生儿期的CS症状不典型,需根据临床、X线检查以及血清学等综合分析进行诊断。母产前定期监测、有效治疗可降低CS的发病率,而新生儿科医师对该病的认识和警惕性有利于患儿得到及时治疗。
Thirteen newborns diagnosed with syphilis were retrospectively analyzed the clinical classification, imaging examination, immunoassay and regular follow-up to explore the influence of the treatment of prematurity Treponema pallidum on neonatal morbidity, congenital syphilis (CS) in neonatal period, The main clinical manifestations. In the neonatal period, 5 cases were diagnosed as CS, 3 cases were suspected and 5 cases were normal. Among 5 cases, 4 cases were diagnosed as untreated, 1 case of RPR titers <4 times before delivery, RPR titers> 1: 4 in 4 cases, neonatal RPR titers ≥ 4 times the mother in 3 cases. CS clinical manifestations of preterm birth, hepatosplenomegaly, rashes. Early changes in the nervous system mainly for cerebrospinal fluid protein. Of the 13 cases, 2 cases were lost to defibrillation, 1 case was diagnosed and 1 case was diagnosed. In the diagnosed group, 1 case was treated repeatedly and 3 cases with RPR titres decreased to different extents. RPR titers of the suspected cases were all negative within 4 months; The group continued to be negative. Conclusion: The symptoms of CS during the neonatal period are not typical. Diagnosis should be based on comprehensive analysis of clinical, X-ray and serology. Prenatal regular monitoring, effective treatment can reduce the incidence of CS, and neonatologists awareness of the disease and vigilance in children with timely treatment.