妊娠期梅毒治疗药物对妊娠结局和新生儿预后的影响研究

Effects of therapeutic drugs on pregnancy outcome and neonate 's prognosis in women patients with syphilis at gestational period

目的通过比较苄星青霉素与头孢曲松治疗妊娠期梅毒的效果,观察其妊娠结局及新生儿预后比较,为治疗妊娠期梅毒提供更佳治疗方案。方法将孕早期及中期确诊妊娠期梅毒患者187例,随机分为试验组85例和对照组102例,孕妇年龄、文化程度、胎次、丈夫感染情况以及RPR滴度无差异,试验组给予头孢曲松1.0 g,1次/d,肌内注射,共10 d治疗,对照组给予苄星青霉素240万U,分两部分给予臀部肌内注射,每周1次,连续3周为1个疗程治疗,孕晚期重复治疗1个疗程。从足月、早产及死胎、死产及新生儿窒息情况观察2组妊娠结局;从新生儿出生后RPR滴度了解新生儿预后;随访其3个月、6个月、12个月、18个月变化,了解其梅毒抗体转阴情况。结果 2组在妊娠结局如早产、死胎及新生儿窒息发生率上差异无统计学意义(P>0.05),婴儿梅毒抗体转阴上差异无统计学意义(P>0.05),经积极治疗后无死胎发生。结论头孢曲松钠和青霉素具有对妊娠梅毒同样的治疗效果。

Objective To compare the therapeutic effects between benzathine penicillin and ceftriaxone on syphilis during pregnancy to observe pregnancy outcome and neonate＇s prognosis in order to provide better therapeutic schedule for women patients with syphilis at gestational period. Methods One hundred and eighty-seven women patients with syphilis at gestational early period and at gestational median period were randomly divided into trail group（ n = 85） and control group（ n = 102）,and there were no obvious differences in age of pregnant women,education degree,frequency of pregnancy,infectious state of their husbands,RPR titer between two groups. The patients in trial group were treated by intramuscular injection with ceftriaxone 1. 0g/day for 10 days,however,the patients in control group were treated by intramuscular injection with benzathine penicillin 2,400,000U/week,for 3 weeks or 6 weeks for women patients with syphilis at gestational late period. The pregnancy outcomes including sufficiency month,premature birth,fetal death,neonatal asphyxia were observed for both groups,and the neonates＇ prognoses were evaluated according to RPR titer,following up for 3 months,6 months,12 months,18 months to observe the changes of negative conversion of syphilis antibody. Results There were no significant differences in pregnancy outcomes including sufficiency month,premature birth,fetal death,neonatal asphyxia between two groups（ P 〉0. 05）,and there were no significant differences in the changes of negative conversion of syphilis antibody between two groups（ P〉 0. 05）,without fetal death after active treatment for both groups. Conclusion The ceftriaxone and benzathine penicillin have the same therapeutic effects on gestational period syphilis.