孕期梅毒低滴度血清固定治疗对新生儿血清学转归的影响

Effect of Therapy for Low Titer Serum Fixation of Syphilis During Pregnancy on the Serological Outcome of Neonates

目的:探讨孕期梅毒低滴度血清固定治疗对新生儿血清学转归的影响.方法:选取2016年8月-2018年8月本院68例孕期梅毒低滴度血清固定患者的临床资料进行回顾性分析,按孕期是否进行治疗干预分为治疗组与未治疗组,每组34例.另选取同期于本院体检的健康孕妇34例作为对照组.治疗组进行孕期低滴度血清固定治疗,未治疗组与对照组孕期不进行任何干预.比较两组孕妇甲苯胺红不加热血清试验(TRUST)滴度情况,新生儿出生时TRUST滴度情况,新生儿梅毒螺旋体明胶凝集试验(TPPA)与TRUST试验结果.比较三组不良妊娠结局.比较治疗组与未治疗组新生儿出生时不同TRUST滴度者TPPA与TRUST转阴时间.结果:治疗组与未治疗组孕妇妊娠1、2、3个月及分娩时血清TRUST滴度比较,差异均无统计学意义(P>0.05).妊娠3个月时,未治疗组中有1例TRUST滴度从1︰1转为1︰2;治疗组中有1例由1︰4转为1︰2.治疗组与未治疗组新生儿出生时TRUST滴度情况比较,差异无统计学意义(P>0.05).治疗组与未治疗组新生儿TRUST与TPPA试验结果比较,差异均无统计学意义(P>0.05).三组低体重新生儿、死胎、自然流产及早产发生率比较,差异均无统计学意义(P>0.05).治疗组与未治疗组出生时TRUST滴度1︰1、1︰2、1︰4的新生儿TPPA转阴时间均长于阴性者(P<0.05).治疗组出生时TRUST滴度1︰4的新生儿TPPA转阴时间短于未治疗组(P<0.05).结论:孕期进行梅毒低滴度血清固定治疗对新生儿TPPA、TRUST阳性率及新生儿TRUST转阴时间不会产生明显的影响,但对高TRUST滴度新生儿的TPPA转阴时间会产生一定的影响.

Objective:To explore the effect of therapy for low titer serum fixation of syphilis during pregnancy on the serological outcome of neonates.Method:The clinical data of 68 patients with low titer serum fixation of syphilis during pregnancy from August 2016 to August 2018 in our hospital were retrospectively analyzed.According to whether treatment intervention was conducted during pregnancy,they were divided into treatment group and no treatment group,with 34 cases in each group.In addition,34 healthy pregnant women underwent physical examination in our hospital during the same period were selected as the control group.The treatment group was given low titer serum fixation of syphilis therapy during pregnancy,while the untreated group and the control group were given no intervention during pregnancy.The titre of toluidine red unheated serum test(TRUST)between pregnant women,the TRUST titers of neonates,treponema pallidum gelatin agglutination test(TPPA)and TRUST test results of neonates in the treatment group and the no treatment group were compared.The adverse pregnancy outcomes among the three groups were compared.The time of TPPA and TRUST turning negative for different TRUST titers at birth of neonates in the treatment group and the no treatment group were compared.Result:There were no significant differences in serum TRUST titer between the treatment group and the no treatment group at 1,2 and3 months of gestation and at delivery(P>0.05).At 3 months of gestation,1 patient in the no treatment group underwent a change in TRUST titer from 1︰1 to 1︰2.In the treatment group,1 patient underwent a change from 1︰4 to 1︰2.There was no significant difference in TRUST titer at birth of neonates between the treatment group and the no treatment group(P>0.05).There were no significant differences in results of TRUST and TPPA test of neonates between the treatment group and the no treatment group(P>0.05).There were no significant differences in the incidence of low birth weight neonates,stillbirths,spontaneous abortions and premature births among the three groups(P>0.05).The TPPA negative conversion time of neonates with TRUST titers of 1︰1,1︰2 and 1︰4 at birth in the treatment group and the no treatment group were longer than those in the negative group(P<0.05).The TPPA negative conversion time of neonates with TRUST titers of 1︰4 in the treatment group was lower than that in the no treatment group(P<0.05).Conclusion:Low titer serum fixed treatment of syphilis during pregnancy has no obvious influence on TPPA,TRUST positive rate and turning negative time of neonates,but has certain influence on TPPA turning negative time of neonates with high TRUST titer.