TRUST法TPPA法检测妊娠合并梅毒血清固定患者的妊娠结局及随访研究

Study on pregnancy outcome and follow-up of pregnancy with sero-fixation of syphilis by TRUST and TPPA method

目的:探讨妊娠合并梅毒血清固定患者的妊娠结局及婴儿的血清学特点。方法:56例妊娠合并梅毒血清固定患者根据孕期是否治疗分为未治疗组(25例)和治疗组(31例)、选择同期80例正常孕妇为正常对照组,比较3组孕妇的妊娠结局,并定期随访婴儿的血清结果。结果:①妊娠结局:未治疗组足月分娩率为88.00%,早产发生率为4.00%,不良结局(自然流产和死胎死产)发生率为8.00%;治疗组分别为90.32%、6.45%和3.22%;正常组分别92.50%、3.75%和3.75%。3组妊娠结局比较,差异无统计学意义(P>0.05)。②新生儿预后:未治疗组分娩正常新生儿占95.65%、早产儿为4.34%、先天梅毒为0;治疗组分别为93.33%、26.67%和0;正常对照组分别为96.10%、3.9%和0。3组新生儿预后比较,差异无统计学意义(P>0.05)。③婴儿血清结果:所有婴儿的19S-IgM-TPPA(-),在随访过程中所没有出现滴度的持续上升,婴儿血TRUST滴度均小于母血TRUST滴度的4倍,TRUST阳性的婴儿在3～6个月内均逐渐阴转;TPPA在6～12月内均逐渐阴转,所有婴儿没有出现梅毒临床症状。结论:妊娠合并梅毒血清固定患者在孕期是否驱梅治疗对妊娠结局无影响。

Objective： To investigate pregnant outcomes of pregnant women with sero - fixation of syphilis and infant＇s serological characteristics. Methods： 56 cases of pregnant women with sero - fixation of syphilis were divided into untreated group （ without anti - syphi- lis therapy during pregnancy, n = 21 ） and treated groups （ n = 35 ）, and 80 cases of normal pregnant women being selected control group. Pregnant outcomes of the three groups were compared and analyzed. And regular follow - ups of infant~ serum were made. Results： ①Pregnant outcomes： the term birth rate was 88%, the incidence of preterm birth was 4%, adverse outcomes （spontaneous abortion and stillbirths ） occurred at a rate of 8% in untreated group. The rates of above indexes were 90. 32% , 6.45% , and 3.22% in the treated group, and were separately 92.5%, 3.75% and 3.75% in the normal group. Difference in pregnant outcomes among the three groups were not significant （P 〉 0. 05 ） . ②The prognosis of neonates ： normal neonates accounted for 95.65%, prematures 4. 34%, congenital syphilis 0 in the untreated group; they were separately 93.33%, 26. 67% and 0 in the treated group; they were separately 96. 10%, 3.9% and 0 in the normal control group. The differences were not statistically significant （ P 〉 0. 05 ） . ③The infant serum results ： the 19S - IgM - TPPA of all infants were negative. During the follow - up process , TRUST titers didnt rise continuously, infant blood TRUST titers was 4 times lower than that of maternal blood. TRUST had been converted into negative gradually after 3 to 6 months, and TPPA were gradually converted into negative after 6 to 12 months. All infants did not have clinical signs of syphilis. Conclusion： Whether to have anti - syphilis therapy during pregnancy has no effect on pregnancy outcome of pregnant women with sero - fixation of syphilis.