基于母婴结局、TRUST滴度评价苄星青霉素G用药不同时机治疗妊娠合并梅毒患者的效果

Evaluation of the effect of benzathine penicillin G in different timings of treatment of pregnant patients with syphilis based on maternal and infant outcomes and toluidine red unheated serum test titers

目的探讨苄星青霉素G不同用药时机治疗妊娠合并梅毒患者的效果及对母婴结局、甲苯胺红不加热血清试验(TRUST)滴度的影响。方法回顾性选取2019年1月至2021年12月临平区分娩单位的119例妊娠合并梅毒患者作为研究对象,根据苄星青霉素G用药时机分为孕早期组(≤13+6周,n=40)、孕中期组(14~27+6周,n=55)和孕晚期组(≥28周,n=24)。三组均给予苄星青霉素G进行治疗,均连续治疗2个疗程。比较三组治疗前后的氧化应激水平,产妇、新生儿TRUST滴度及母婴结局。结果与治疗前比较,治疗后三组血清隐性氧化蛋白产物(AOPP)、丙二醛(MDA)水平均降低,孕早期组均低于孕晚期组、孕中期组;与治疗前比较,治疗后三组血清超氧化物歧化酶(SOD)水平均升高,孕早期组高于孕晚期组、孕中期组;与孕晚期组、孕中期组比较,孕早期组患者及新生儿的TRUST阴性率、新生儿体重、出生后5 min Apgar评分均升高,先天梅毒儿、早产发生率均较低,差异具有统计学意义(P<0.05)。结论在孕早期采用苄星青霉素G治疗妊娠合并梅毒患者可有效改善其氧化应激水平,改善妊娠结局和围产儿的预后情况,提高产妇及新生儿的TRUST阴性率,减少先天梅毒儿、早产的发生。

Objective To investigate the effect of benzathine penicillin G at different times in the treatment of pregnant patients with syphilis and its effects on maternal and infant outcomes and toluidine red unheated serum test(TRUST)titers.Methods A total of 119 pregnant patients with syphilis who were admitted to Linping district delivery unit from January 2019 to December 2021 were retrospectively selected as research subjects and divided into first trimester group(≤13~(+6)weeks,n=40)and second trimester group(14-27~(+6)weeks,n=55)and the third trimester group(≥28 weeks,n=24).All three groups were treated with benzathine penicillin G for 2 consecutive courses.The oxidative stress levels before and after treatment,maternal and neonatal TRUST titers,and maternal and infant outcomes were compared among the three groups.Results Compared with before treatment,serum adanced oxidation protein products(AOPP)and malondialdehyde(MDA)levels in the three groups decreased after treatment,and the first trimester group was lower than the third trimester group and the second trimester group.Compared with those before treatment,the serum superoxide dismutase(SOD)levels of the three groups increased after treatment,and the first trimester group was higher than the third trimester group and the second trimester group.Compared with the third trimester group and the second trimester group,the TRUST negative rate,neonatal body weight,and Apgar score 5 minutes after birth were higher in the first trimester group,and the incidences of congenital syphilis and premature birth were lower,the differences were statistically significant(P0.05).Conclusions The use of benzathine penicillin G in the treatment of pregnant patients with syphilis in the first trimester can effectively improve the level of oxidative stress,improve the outcome of pregnancy and the prognosis of perinatal infants,increase the TRUST negative rate of mothers and newborns,and reduce the incidence of congenital syphilis and premature birth.