摘要
目的探讨新生儿登革热病例的临床表现和实验室检查特征。方法回顾性分析2014年广东省妇幼保健院和中山大学附属广州市妇女儿童医学中心收治的新生儿登革热共12例的临床资料，并进行相关文献复习。结果12例登革热患儿男9例，女3例；年龄生后30min～29d，发病年龄为生后30rain-24d。（1）临床特征：发热11例，皮疹6例，出血点1例，黄疸5例，咳嗽l例，凝血功能异常2例。（2）母亲围产期情况：确诊登革热7例，疑似登革热2例，排除登革热3例。母亲产前发热8例。（3）实验室检查：血小板减少11例（19×10^9-156×10^9／L），部分活化凝血酶原时间延长11例（44．0～89．8s），纤维蛋白原降低5例（1．17—3．02g／L），天冬氨酸转氨酶（AST）升高5例（28～78U／L），肌酸激酶同工酶（CK．MB）升高4例（13—86U／L），低钾血症1例（2．8—5．1mmoL／L），C反应蛋白（CRP）增高6例（0．04—46．05mg／L）。（4）治疗及预后：输注血小板2例，抗感染6例，静脉注射丙种球蛋白治疗5例，住院时间4～17d，10例治愈，2例病情好转后自动出院。以“新生儿登革热”为关键词，在万方、维普、CNKI全文数据库中检索国内文献，未见相关报道。以“neonataldengue”“casereport”作为关键词通过Pubmed检索1990至2014年的文献，共检索到15篇文献，其中报道的30例登革热病毒感染患儿均为母婴垂直传播，主要的临床表现有发热、皮疹、瘀斑、贫血、黄疸、心率增快、肝肿大；实验室检查均可见血小板减少，经抗感染、输注血小板及对症治疗，30例患儿均治愈。结论新生儿登革热临床表现以发热、凝血功能障碍为主。临床症状较轻缺乏特异性，预后良好。母婴垂直传播是感染登革病毒传染途径之一。
Objective To explore the clinical manifestations and laboratory examination characteristics of neonatal dengue fever. Method A retrospective analysis of 12 cases of neonatal dengue fever treated in the Guangdong Women and Children＇s Hospital and Guangzhou Women and Children＇s Medical Center was conducted, and related literature was reviewed. Result Twelve cases of neonatal dengue fever included 9 males and 3 females ; their age was 30 min after birth to 29 d, the age of onset was 30 rain - 24 d. （1） Clinical features： fever was present in 11 cases, rash in 6 cases, bleeding in 1 case, jaundice in 5 cases, cough in 1 case, coagulopathy in 2 cases. （2） Mothers＇ perinatal conditions： 7 mothers were confirmed to have dengue fever, 2 mothers had suspected dengue fever, and in 3 mothers the dengue fever was excluded. Eight mothers prenatally had fever. （3） Laboratory tests： Thrombocytopenia was found in 11 cases （ 19 ×10^9- 156 ×10^9/L） , activated partial thromboplastin time prolonged in 11 cases （44.0 - 89. 8 s）, fibrinogen decreased in 5 cases （1.17 -3.02 g/L）, aspartate aminotransferase （AST） increased in 5 cases （28 - 78 U/L） , creatine kinase （CK-MB） increased in 4 eases （ 13 - 86 U/L） , hypokalemia in1 case （2. 8 -5. 1 mmol/L ）, C- reactive protein （CRP） increased in 6 cases （0. 04 -46. 05 mg/L）. （4） Treatment and prognosis： platelet transfusion was used in 2 cases, anti-infective therapy was given to 6 cases, intravenous gamma globulin treatment was used in 5 cases, hospitalization was 4 - 17 d, 10 cases were cured, 2 cases were discharged after condition was improved. Literature search was performed with ＂ neonatal dengue＂ as keywords at Wanfang, Weipu, and CNKI, no relevant reports were found. Pubmed search was done with ＂neonatal dengue＂ and ＂ case report＂ as keywords, 15 reports were retrieved during 1990 and 2014, which reported 30 cases, all acquired the disease via vertical transmission; the main clinical manifestations w
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2015年第12期943-947,共5页
Chinese Journal of Pediatrics
关键词
登革热
婴儿
新生儿
传染性疾病传播
垂直
Dengue
Infant, newborn
Infectious disease transmission, vertical
