新生儿水痘的临床特征
The Clinical Feature of Neonatal Varicella
DOI: 10.12677/ACM.2022.125711, PDF,   
作者: 朱 静：重庆医科大学附属儿童医院感染科，儿童发育疾病研究教育部重点实验室，国家儿童健康与疾病临床医学研究中心，儿童发育重大疾病国家国际科技合作基地，儿童感染免疫重庆市重点实验室，重庆
关键词: 新生儿；水痘；临床特征；Neonate； Varicella； Clinical Feature
摘要: 目的：探讨新生儿水痘的临床特征。方法：回顾分析2011年1月至2021年6月收治的68例新生儿水痘的临床资料。结果：68例患儿中通过垂直传播被感染54例(79.4%)，仅4例无明确水痘患者接触史，1月及12月为发病高峰。所有患儿均有典型皮疹，伴随发热症状45例(66.2%)，并发皮肤细菌感染者46例(67.6%)，并发肺炎者43例(63.2%)，并发脑炎者7例(63.2%)，并发肝炎者6例(8.8%)，无并发症者4例(5.9%)，重症水痘7例(10.3%)。60例接受静脉注射用免疫球蛋白治疗，29例接受静脉阿昔洛韦治疗，并发细菌感染予以抗生素治疗，最终死亡3例(4.4%)。结论：新生儿水痘临床表现典型，并发症多，有较高的病死率，应积极治疗，重在预防。
Abstract: Objective: To explore the clinical feature of neonatal varicella. Methods: The clinical data of 68 neo-nates with varicella admitted from January 2011 to June 2021 were retrospectively analyzed. Re-sults: Among 68 cases, 54 cases (79.4%) were infected through vertical transmission, and only 4 cases had no clear history of exposure to varicella, and the peak incidence was in January and De-cember. All of the cases had the typical skin rashes, including 45 cases (66.2%) with fever, 46 cases (67.6%) with bacterial infection, 43 cases (63.2%) with pneumonia, 7 cases (63.2%) with encepha-litis, 6 cases (8.8%) with hepatitis, 4 cases (5.9%) without complications, and 7 cases (10.3%) with severe varicella. 60 patients were treated with intravenous immunoglobulin, 29 cases with intra-venous acyclovir, and antibiotics for bacterial infection, resulting in 3 deaths (4.4%). Conclusions: The clinical manifestations of neonatal varicella are typical, with many complications and a high mortality rate. It should be actively treated, focusing on prevention.
文章引用：朱静. 新生儿水痘的临床特征[J]. 临床医学进展, 2022, 12(5): 4903-4908. https://doi.org/10.12677/ACM.2022.125711

参考文献

[1] 江载芳, 主编. 诸福棠实用儿科学[M]. 北京: 人民卫生出版社, 2014.
[2] Ahn, K.H., Park, Y.J., Hong, S.C., Lee, E.H., Lee, J.S., Oh, M.J. and Kim, H.J. (2016) Congenital Varicella Syndrome: A Systematic Review. Journal of Ob-stetrics and Gynaecology, 36, 563-566. [Google Scholar] [CrossRef] [PubMed]
[3] Lamont, R.F., Sobel, J.D., Carrington, D., et al. (2011) Varicella-Zoster Virus (Chickenpox) Infection in Pregnancy. BJOG: An International Journal of Obstetrics & Gynae-cology, 118, 1155-1162. [Google Scholar] [CrossRef] [PubMed]
[4] 王佳丽, 夏爱梅. 78例新生儿水痘的护理[J]. 中华护理杂志, 2018, 53(9): 1092-1095. [Google Scholar] [CrossRef] 
[5] Bakker, K.M., Martinez-Bakker, M.E., Helm, B. and Stevenson, T.J. (2016) Digital Epidemiology Reveals Global Childhood Disease Seasonality and the Effects of Immun-ization. Proceedings of the National Academy of Sciences of the United States of America, 113, 6689-6694. [Google Scholar] [CrossRef] [PubMed]
[6] 刘新晖, 高喜容, 罗如平, 杨慧, 张蜜. 14例新生儿水痘分析[J]. 实用预防医学, 2012, 19(10): 1525-1526.
[7] Lo Presti, C., Curti, C., Montana, M., Bornet, C. and Vanelle, P. (2019) Chickenpox: An Update. Médecine et Maladies Infectieuses, 49, 1-8. [Google Scholar] [CrossRef] [PubMed]
[8] Sauerbrei, A. and Wutzler, P. (2001) Neonatal Varicella. Jour-nal of Perinatology, 21, 545-549. [Google Scholar] [CrossRef] [PubMed]
[9] Gershon, A.A., Breuer, J., Cohen, J.I., Cohrs, R.J., Gershon, M.D, Gilden, D., Grose, C., Hambleton, S., Kennedy, P.G., Oxman, M.N., Seward, J.F. and Yamanishi, K. (2015) Varicella Zoster Virus Infection. Nature Reviews Disease Primers, 1, Article ID: 15016. [Google Scholar] [CrossRef] [PubMed]
[10] Miller, E., Cradock-Watson, J.E. and Ridehalgh, M.K. (1989) Outcome in Newborn Babies Given Anti-Varicella- Zoster Immunoglobulin after Perinatal Maternal Infection with Varicella-Zoster Virus. The Lancet, 2, 371-373. [Google Scholar] [CrossRef] 
[11] Belay, E.D., Bresee, J.S., Holman, R.C., Khan, A.S., Shah-riari, A. and Schonberger, L.B. Reye’s Syndrome in the United States from 1981 through 1997. The New England Jour-nal of Medicine, 340, 1377-1382.[CrossRef] 
[12] Souyri, C., Olivier, P., Grolleau, S. and Lapeyre-Mestre, M. (2008) French Network of Pharmacovigilance Centres. Severe Necrotizing Soft-Tissue Infections and Nonsteroidal An-ti-Inflammatory Drugs. Clinical and Experimental Dermatology, 33, 249-255. [Google Scholar] [CrossRef] [PubMed]
[13] Castillo, S.A., Pham, A.K. and Dinulos, J.G. (2017) Cu-taneous Manifestations of Systemic Viral Diseases in Neonates: An Update. Current Opinion in Pediatrics, 29, 240-248. [Google Scholar] [CrossRef] 
[14] Holland, C. and Sadarangani, M. (2020) Fifteen-Minute Consultation: Prevention and Treatment of Chickenpox in Newborns. ADC Education & Practice, 105, 24-30. [Google Scholar] [CrossRef] [PubMed]
[15] Sauerbrei, A. and Wutzler, P. (2007) Herpes Simplex and Varicella-Zoster Virus Infections during Pregnancy: Current Concepts of Prevention, Diagnosis and Therapy. Part 2: Varicella-Zoster Virus Infections. Medical Microbiology and Immunology, 196, 95-102. [Google Scholar] [CrossRef] [PubMed]
[16] Prober, C.G., Gershon, A.A., Grose, C., McCracken Jr., G.H. and Nelson, J.D. (1990) Consensus: Varicella-Zoster Infections in Pregnancy and the Perinatal Period. The Pediatric In-fectious Disease Journal, 9, 865-869. [Google Scholar] [CrossRef] 
[17] Nathwani, D., Maclean, A., Conway, S. and Carrington, D. (1998) Varicella Infections in Pregnancy and the Newborn. A Review Prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. Journal of Infection, 36, 59-71. [Google Scholar] [CrossRef] 
[18] Levin, M.J., Duchon, J.M., Swamy, G.K. and Gershon, A.A. (2019) Varicella Zoster Immune Globulin (VARIZIG) Administration up to 10 Days after Varicella Exposure in Pregnant Women, Immunocompromised Participants, and Infants: Varicella Outcomes and Safety Results from a Large, Open-Label, Expanded-Access Program. PLoS ONE, 14, e0217749. [Google Scholar] [CrossRef] [PubMed]
[19] Paryani, S.G., Arvin, A.M., Koropchak, C.M., et al. (1984) Comparison of Varicella Zoster Antibody Titers in Patients Given Intravenous Immune Serum Globulin or Varicella Zoster Immune Globulin. The Journal of Pediatrics, 105, 200-205. [Google Scholar] [CrossRef] 
[20] 魏国义, 胡仪吉. 抗病毒药物的化学结构及药理作用[J]. 中国实用儿科杂志, 2001, 16(8): 454-456.
[21] Cohen, J. and Breuer, J. (2015) Chickenpox: Treatment. Clinical Evi-dence, 2015, Article No. 912.
[22] 王莉, 樊卓, 覃净静, 徐锐, 王丹. 水痘-带状疱疹病毒治疗的研究进展[J]. 中华传染病杂志, 2017, 35(9): 571-573.
[23] Sauerbrei, A. (2016) Diagnosis, Antiviral Therapy, and Prophylaxis of Varicella-Zoster Virus Infections. European Journal of Clinical Microbiology & Infectious Diseases, 35, 723-734. [Google Scholar] [CrossRef] [PubMed]
[24] Downes, K.J., Boge, C.L.K., Baro, E., et al. (2020) Acute Kidney Injury during Treatment with Intravenous Acyclovir for Suspected or Confirmed Neonatal Herpes Simplex Virus Infec-tion. The Journal of Pediatrics, 219, 126-132.E2. [Google Scholar] [CrossRef] [PubMed]
[25] 刘盈. 突破性水痘及预防[J]. 中华儿科杂志, 2021, 59(1): 75-77. [Google Scholar] [CrossRef] [PubMed]
[26] 邱凌娴, 余小娟, 苏迎盈, 程通, 吴婷. 水痘疫苗的临床研究进展[J]. 中华微生物学和免疫学杂志, 2019, 39(12): 951-957.
[27] Smith, C.K. and Arvin, A.M. (2009) Varicella in the Fetus and Newborn. Seminars in Fetal and Neonatal Medicine, 14, 209-217. [Google Scholar] [CrossRef] [PubMed]
[28] Hanaoka, M., Hisano, M., Watanabe, N., Sugawara, K., Kambe, Y., Kanda, E., Sago, H., Kato, T. and Yamaguchi, K. (2013) Changes in the Prevalence of the Measles, Rubella, Varicel-la-Zoster, and Mumps Virus Antibody Titers in Japanese Pregnant Women. Vaccine, 31, 2343-2347. [Google Scholar] [CrossRef] [PubMed]
[29] Swamy, G.K. and Heine, R.P. (2015) Vaccinations for Preg-nant Women. Obstetrics & Gynecology, 125, 212-226. [Google Scholar] [CrossRef] 
[30] Shrim, A., Koren, G., Yudin, M.H. and Farine, D. (2018) No. 274-Management of Varicella Infection (Chickenpox) in Pregnancy. Journal of Obstetrics and Gynaecology Cana-da, 40, E652-E657. [Google Scholar] [CrossRef] [PubMed]

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