抗梅毒治疗时机和梅毒TRUST滴度对梅毒孕妇妊娠结局的影响研究

Effect of anti-syphilis treatment and syphilis TRUST titer on the pregnant outcome of pregnant women with syphilis

目的:探讨抗梅毒治疗和梅毒TRUST滴度对梅毒孕妇妊娠结局的影响。方法:选取2013年5月至2015年9月我院收治的72例妊娠期梅毒患者作为观察组研究对象,选取60例同期健康孕产妇作为对照组,观察组根据治疗时机分为四组:A组(14例)在孕12周内予以驱梅治疗,B组(18例)在孕28周后予以治疗;C组(24例)整个孕期均进行驱梅治疗;D组(16例)孕期未给予驱梅治疗。比较两组及观察组不同治疗时机、TRUST滴度的妊娠结局和新生儿情况。结果:观察组早产、流产、死胎发生率及新生儿低出生体重、先天梅毒、死亡率均明显高于对照组,TRUST滴度≥1∶8时明显高于TRUST滴度<1∶8,差异有统计学意义(P<0.05);D组不良妊娠结局发生率(81.4%)明显高于A组(50.0%)、B组(55.6%)及C组(33.4%),差异有统计学意义(P<0.05);不良妊娠结局发生率大小依次为:D组>B组>A组>C组;A组新生儿情况明显好于B、C、D组,差异有统计学意义(P<0.05),C、B、D组次之。结论:抗梅毒治疗时机和梅毒TRUST滴度对梅毒孕妇妊娠结局及新生儿预后具有重要影响。

Objectives： To investigate the effect of anti - syphilis treatment and syphilis TRUST titer on the pregnancy outcome of pregnant women with syphilis. Methods： The 72 pregnant patients with syphilis in our hospi- tal from May 2013 to September 2015 were selected as the observation group, and the 60 healthy pregnant women were selected as a control group. The pregnant outcome and neonatal status at different treatment time and TRUST titer of the two groups were compared. Results： The premature delivery, abortion, fetal death occurrence rate and neonatal low birth weight, congenital syphilis and mortality of the observation group were significantly higher than the control group. The titer of TRUST greater than or equal to 1 ： 8 was significantly higher than the titer of TRUST less thanl ： 8, with statistically significant difference （ P 〈 0. 05 ）. The incidence of adverse pregnancy outcome in group D （ 81.4% ） was significantly higher than group A （ 50.0% ）, group B （ 55.6% ） and group C （ 33.4% ）, all with statistically significant difference （ P 〈 0. 05 ）. The occurrence rate of adverse pregnancy outcome was as fol- lows ： group D 〉 group B 〉 group A 〉 group C. Neonatal situation of group A was significantly better than group B, C, D, with statistically significant difference （ P 〈 0.05 ）, followed by group C, B and D. Conclusious： The timing and TRUST titer of anti - syphilis treatment in pregnant women with syphilis have important influence on the preg- nant outcome and neonatal prognosis.