不同孕周使用头孢曲松钠序贯苄星青霉素治疗妊娠期梅毒对孕妇氧化应激水平和新生儿健康状况的影响

Effects of Sequential Ceftriaxone Benzathine Penicillin in Different Gestational Weeks on Syphilis During Pregnancy on Oxidative Stress of Pregnant Women and Health Status of Neonates

目的探讨头孢曲松钠序贯苄星青霉素治疗不同孕周妊娠期梅毒的对患者氧化应激及新生儿的影响。方法选取2015年1月至2018年7月治疗的妊娠梅毒患者150例,根据开始治疗的孕周时间分为A组(孕周≤12周)、B组(孕周13~27周)和C组(≥28周),各组均给予头孢曲松钠序贯苄星青霉素治疗,观察各组母婴结局,同时检测患者治疗前后氧化应激水平。结果 A组治疗疗效明显优于B组和C组,其总有效率为97.50%,差异有统计学意义(P<0.05);A组治疗后1个月隐性氧化蛋白产物(AOPP)和丙二醛(MDA)分别为(48.84±8.22)"mol/L和(3.20±0.84) nmol/L,明显低于B组和C组,而超氧化物歧化酶(SOD)为(134.46±20.26) NU/m L,明显高于B组和C组,差异有统计学意义(P<0.05);A组早产比例为1.33%,明显低于B组和C组,差异有统计学意义(P <0.05);A组新生儿体质量和出生后5min Apgar评分分别为(3.38±0.87) kg和(9.12±0.99)分,明显高于B组和C组,而先天梅毒儿发生率为0,明显低于B组和C组,差异有统计学意义(P<0.05)。结论对于妊娠期梅毒患者,孕周≤12周前进行头孢曲松钠序贯苄星青霉素治疗,能有效改善母婴结局,改善患者氧化应激水平。

Objective To investigate the effect of ceftriaxone sequential benzathine penicillin in different gestational weeks on pregnancy syphilis on oxidative stress and neonates.Methods 150 pregnant syphilis patients who were treated from January 2015 to July 2018 were selected and divided into group A (gestational week ≤12 weeks),group B (gestational weeks 13-27 weeks) and group C (≥28 weeks) according to the gestational time of starting treatment,each group was given ceftriaxone sequential benzathine penicillin treatment.Then,the maternal and infant outcomes of each group were observed,andoxidative stress levels before and after treatment were detected.Results The therapeutic effect of group A was significantly better than that of groups B and C,and the total effective rate was 97. 50% with statistically significant difference (P<0. 05).The latent oxidized protein product (AOPP) and malondialdehyde (MDA) in group A were (48. 84±8. 22) mol/L and (3. 20±0. 84) nmol/L,which were significantly lower than those in group B and C group,while the superoxide dismutase (SOD) was (134. 46±20. 26) NU/m L,significantly higher than group B and group Cwith statistically significant difference (P<0. 05).The premature birth rate of group A was 1. 33%,which was significantly lower than that of group B and group Cwith statistically significant difference (P<0. 05).The weight of the newborn in group A and the Apgar score at 5 minutes after birth were (3. 38± 0. 87) kg and (9. 12± 0. 99) respectively,which were significantly higher than those in groups B and C.The incidence of congenital syphilis was 0%,which was significantly lower than that in groups B and Cwith statistically significant difference (P<0. 05).Conclusion For patients with syphilis during pregnancy,ceftriaxone sequential benzathine penicillin treatment before gestational week ≤12 weeks could effectively improve maternal and infant outcomes and improve patients’ oxidative stress level.