上海市64例早期先天梅毒调查分析  

Survey of 64 early congenital syphilis cases in Shanghai

作　　者：王丽珍[1] 朱丽萍[1] 钱尚萍[1] 

机构地区：[1]上海市第一妇婴保健院,上海市妇女保健所,200040

出　　处：《中国妇幼保健》2002年第9期564-566,共3页Maternal and Child Health Care of China

摘　　要：目的 :研究上海市先天梅毒的发病现况及其在诊断、治疗、随访中的问题 ,为制定措施提供参考意见。方法采用回顾性个案调查方法 ,对象是 2 0 0 0年 1～ 6月 1年半中上海市二、三级医院传报的先天梅毒病例。调查内容包括母儿一般情况 ,先天梅毒的诊断、治疗、随访、母亲孕期的梅毒治疗情况等 ,结果 1年半中传报 90例 ,调查 6 4例均为早期先天梅毒 ,月龄 1h到 6个月。临床表现主要为早产、低体重、皮疹、肝脾肿大及长骨 X光异常等。血清学检查测 RPR6 3例阳性 71.9% ,测 TPHA4 7例阳性 10 0 % ,仅 1例测 19S- Ig M- FTA- ABS为阳性 ,根据检查结果确诊早期先天梅毒 13例 (2 0 .3% ) ,拟诊 4 5例 (70 .3% ) ,6例 (9.4 0 % )不能确诊也不能拟诊 ,治疗率 90 .6 %。随访 1次 2 4例(37.5 % )、 2次 9例 (14 .1% )、 3次 3例 (4.7% )。结论与建议 :1本市先天梅毒的分布以市区为主 ;2母亲妊娠梅毒于 16 w以前治疗 ,用两个疗程足量青霉素可积极预防先天梅毒儿出生 ;3诊断新生儿先天梅毒缺乏金标准 ,应大力开展 19S- Ig M- FTA- ABS及暗视野显微镜检查 ;4新生儿的随访不足 ,应大力开展健康教育 ,以提高随访的自觉性。Objective: To study the prevalence of early congenital syphilis in Shanghai and its diagnosis therapy and follow up so as to provide some suggestions to take some corresponding reviewed measures. Methods: Retrospective study was used for every case. The early congenital syphilis cases were reported by the secondary and tertiary hospitals from Jan. 2001. Unified questionnaire were used to correct information which included: mother and infant's status, diagnosis and therapy of congenital syphilis, therapeutic progress in pregnancy, et al. Results: During this period, there were 90 cases reported and 64 cases were surveyed. The age of infant varied from 1 day to 6 months. The symptoms included premature delivery, low birth weight, rash, liver and spleen swelling as well as abnormality of long bone in X ray. Serological test results were as follows. 71.9% RPR positive in 63 cases, 100% TPHA positive in 47 cases, and only 1 case was 19S IgM FTA ABS positive. According to the test results, 13 cases(20.3%) were confirmed and 45 cases (70.39%) were suspected to be early congenital syphilis, 6 cases (9.4%) needed further proof. The therapy rate was 90.69% . The follow up survey rate was 37.5% once, 14.9% for three times. Conclusion: (1) early congenital syphilis in Shanghai mainly happened in urban districts;(2) pregnant women with syphilis should be treated before 16 weeks. Two periods of enough penicillin treatment could prevent congenital syphilis;(3) there is no golden standard in the diagnosis of congenital syphilis.19S IgM FTA ABS and dark field microscopy test should be taken; (4) the follow up survey rates of infants are low. Health education aimed at raising the general public's consciousness should be taken.

关 键 词：上海 调查 先天梅毒 诊断 治疗 

分 类 号：R759.15[医药卫生—皮肤病学与性病学]