胎婴儿先天性梅毒5例尸检分析  

Congenital syphilis:a clinicopathologic study of 5 autopsy cases

作　　者：葛素梅 邢宝玲 欧阳俊 强贤 李婷 刘梦璐 焦炼 

机构地区：[1]常州市妇幼保健院病理科,江苏常州213003

出　　处：《诊断病理学杂志》2013年第9期553-556,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胎婴儿先天性梅毒的诊断、鉴别诊断及临床病理学特征。方法尸体解剖观察大体形态,显微镜下观察主要脏器的组织学改变,结合文献探讨该病的临床表现、病理形态学特点。结果胎婴儿先天性梅毒可侵犯全身任何组织,以肝、胰、脾等实质性器官最为明显,病理改变主要为多脏器纤维化,胎盘苍白肿大。结论梅毒病孕妇的梅毒螺旋体可以通过胎盘进入胎儿血液,并通过血液循环播散至肝、胰、脾、心肺、肾上腺大量增殖,导致胎儿感染、流产、早产或死胎,胎婴儿先天性梅毒临床表现复杂,临床诊断主要依据病史,各类血清学检查。Purpose To observe the clinicopathologic features of congenital syphilis and to study the diagnosis and differential diagnosis. Methods The gross morphology was observed by autopsy and histological changes of major organs under microscope. The clinical manifestation and clinicopathological features were discussed with review of the related literature. Results Congenital syphilis involved many different organs, especially liver, pancreas, and spleen. The main histological characteristics were multiple organ fibrosis, and placental enlargement. Conclusions Spirochaeta pallidum in the syphilitic mother enters the fetal blood through placenta, disseminates to multiple organs such as liver, pancreatic gland, spleen, heart and lungs, adrenal gland through blood circulation, and proliferates there, and results in infection of fetus, abortion, premature delivery, and even fetal death. The clinicopathological features and pathological changes of congenital syphilis are very complicated, and the clinical diagnosis depends on history of disease and serum test.

关 键 词：先天性梅毒 尸检 胎婴儿 病理特点 

分 类 号：R759.151[医药卫生—皮肤病学与性病学]