新生儿B族链球菌脑膜炎的临床特点分析  

Analysis of clinical characteristics of neonates with group B streptococcal meningitis

作　　者：黄晓玲[1] 郭继忠[1] 翁立坚[1] 杨斯岚[1] HUANG Xiao-ling;GUO Ji-zhong;WENG Li-jian;YANG Si-lan(Department of Neonatology,The First Affiliated Hospital of Shantou University Medical College,Shantou,Guangdong 515041,China)

机构地区：[1]汕头大学医学院第一附属医院新生儿科,广东汕头515041

出　　处：《中国妇幼保健》2025年第4期646-649,共4页Maternal and Child Health Care of China

基　　金：广东省汕头市医疗卫生科技计划项目(财政资金支持项目)(汕府科〔2018〕11号-1)。

摘　　要：目的通过分析B族链球菌(group B streptococcus,GBS)感染引起的新生儿细菌性脑膜炎的临床特点,探讨新生儿GBS脑膜炎的诊断与治疗策略。方法选取2013—2019年汕头大学医学院第一附属医院新生儿科收治的新生儿细菌性脑膜炎患儿162例,其中GBS脑膜炎12例(GBS脑膜炎组),非GBS脑膜炎150例(非GBS脑膜炎组)。对比分析两组患儿的临床表现、实验室检查、影像学检查及预后。结果与非GBS脑膜炎组相比,GBS脑膜炎组患儿更易发生惊厥、发绀,更容易并发败血症;GBS脑膜炎组患儿降钙素原、C-反应蛋白、脑脊液白细胞数及脑脊液蛋白水平均较非GBS脑膜炎组患儿显著上升,脑脊液葡萄糖浓度则显著降低;GBS脑膜炎组患儿病情更重、并发症更多、疗程与住院时间更长。结论GBS患儿更易发生惊厥、发绀等神经系统症状,更易并发败血症,病情重、并发症多、疗程长。因此,产前预防、早期发现并及时有效治疗对新生儿GBS脑膜炎的诊治和预后有重要意义。Objective The clinical characteristics of neonatal bacterial meningitis caused by group B streptococcus(GBS)infection were analyzed to explore the diagnosis and treatment strategy of neonatal GBS meningitis.Methods A retrospective review was performed on 162 neonates with purulent meningitis hospitalized in The First Affiliated Hospital of Shantou University Medical College Neonatology Department from 2013 to 2019,including 12 cases of GBS meningitis(GBS meningitis group)and 150 cases of non-GBS meningitis(non-GBS meningitis group).The clinical manifestations,laboratory examination,imaging examination and prognosis of the two groups were compared and analyzed.Results Compared with non-GBS meningitis group,the neonates in GBS meningitis group were more likely to have convulsion,cyanosis and sepsis.The levels of procalcitonin,C-reactive protein,white blood cell count and CSF protein in GBS meningitis group were significantly higher than those in non-GBS meningitis group,while the concentration of CSF glucose was significantly lower.Neonates with GBS meningitis had more severe illness,more complications,longer duration of treatment and hospital stay.Conclusion Neonates with GBS are more likely to have convulsion,cyanosis and other neurological symptoms,more likely to be complicated with sepsis,serious illness,more complications,long course of treatment.Therefore,prenatal prevention,early detection and timely and effective treatment are of great significance for the diagnosis,treatment and prognosis of neonatal GBS meningitis.

关 键 词：B族链球菌 细菌性脑膜炎 新生儿 

分 类 号：R722.1[医药卫生—儿科]