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...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。展开更多
Background: So far, there is a paucity of real-world data on the syphilis serological responses to the first-line treatment during pregnancy, and there is no relevant study on the necessity of anti-syphilis treatment ...Background: So far, there is a paucity of real-world data on the syphilis serological responses to the first-line treatment during pregnancy, and there is no relevant study on the necessity of anti-syphilis treatment during pregnancy for those patients who have been treated for syphilis before pregnancy for the prevention of mother-to-child transmission, which might provide valuable insight into treatment effectiveness and optimal management of pregnant women with syphilis.Methods: A retrospective study on 10 years of real-world data was performed for accumulative 410 Chinese pregnant women with syphilis. The descriptive statistics were conducted in the study, and toluidine red unheated serum test (TRUST) titer responses to penicillin treatment in syphilis-infected pregnant women, and the associations with congenital syphilis were investigated. We divided the patients into two groups according to the history of anti-syphilis treatment before pregnancy (patients diagnosed with syphilis who had received anti-syphilis treatment before pregnancy, and patients screened and diagnosed with syphilis during pregnancy who had no previous history of anti-syphilis treatment).Results: The rate of congenital syphilis in this study was 6.2% (25/406). There was no significant difference in the rate of congenital syphilis between patients who received anti-syphilis treatment before pregnancy and those who did not. Secondary syphilis and high baseline serum TRUST titer (≥1:8) in pregnant women were independent risk factors for congenital syphilis.Conclusions: For the prevention of congenital syphilis, anti-syphilis treatment during pregnancy for syphilis seropositive pregnant women is needed, regardless of whether the patient has received anti-syphilis treatment before pregnancy, especially for those patients with secondary syphilis or high baseline serum TRUST titer, thus, timely surveillance, early diagnosis to timely treatment, and close syphilis reexamination during posttreatment follow-up, may help to reduce the above-mentioned risk factors for congenital syphilis.展开更多
目的 探讨甲苯胺红快速血浆反应素试验（TRUST）在梅毒传染性中的诊断价值和临床意义。 方法 收集酶联免疫吸附试验（ELISA）和梅毒螺旋体颗粒凝集试验（TPPA）试验均阳性的住院患者血清73例，再用TRUST试验和梅毒螺旋体IgM抗体蛋白...目的 探讨甲苯胺红快速血浆反应素试验（TRUST）在梅毒传染性中的诊断价值和临床意义。 方法 收集酶联免疫吸附试验（ELISA）和梅毒螺旋体颗粒凝集试验（TPPA）试验均阳性的住院患者血清73例，再用TRUST试验和梅毒螺旋体IgM抗体蛋白印迹试验（TP-IgM）进行检测，采用SPSS 16.0软件建库统计指标计算与分析两种试验的结果。 结果 随着TRUST滴度的升高，TP-IgM的阳性率也升高，差异有统计学意义（H=7.267, P 〈0.05）。经两两比较，TRUST阴性与阳性组滴度〈1∶8的TP-IgM阴阳性没有统计学意义（H=0.141, P 〉0.05）；TRUST阴性与阳性组滴度≥1∶8的TP-IgM阴阳性有统计学意义（H=5.909, P 〈 0.05 ）；TRUST阳性组滴度〈1∶8与滴度≥1∶8的TP-IgM阴阳性有统计学意义（H=5.859, P 〈0.05）。TRUST、TP-IgM阴性组和阳性组（包括弱阳性、阳性和TRUST〈1∶8）一致性检验差（Kappa=0.011， P = 0.916 ），TRUST、TP-IgM阴性组（包括阴性、弱阳性和TRUST〈1∶8）和阳性组一致性检验差（Kappa= 0.006 ， P =0.951）。 结论 TRUST试验对梅毒传染性有较好的诊断价值，特别在滴度≥1∶8时，临床工作者更应该注意其传染性；对TRUST阴性和滴度〈1∶8时，TP-IgM是判断标本有无传染性的补充指标。展开更多
文摘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。
基金supported by a grant from the Beijing Scienceand,Technology Planningprojects(No.Z181100001718140).
文摘Background: So far, there is a paucity of real-world data on the syphilis serological responses to the first-line treatment during pregnancy, and there is no relevant study on the necessity of anti-syphilis treatment during pregnancy for those patients who have been treated for syphilis before pregnancy for the prevention of mother-to-child transmission, which might provide valuable insight into treatment effectiveness and optimal management of pregnant women with syphilis.Methods: A retrospective study on 10 years of real-world data was performed for accumulative 410 Chinese pregnant women with syphilis. The descriptive statistics were conducted in the study, and toluidine red unheated serum test (TRUST) titer responses to penicillin treatment in syphilis-infected pregnant women, and the associations with congenital syphilis were investigated. We divided the patients into two groups according to the history of anti-syphilis treatment before pregnancy (patients diagnosed with syphilis who had received anti-syphilis treatment before pregnancy, and patients screened and diagnosed with syphilis during pregnancy who had no previous history of anti-syphilis treatment).Results: The rate of congenital syphilis in this study was 6.2% (25/406). There was no significant difference in the rate of congenital syphilis between patients who received anti-syphilis treatment before pregnancy and those who did not. Secondary syphilis and high baseline serum TRUST titer (≥1:8) in pregnant women were independent risk factors for congenital syphilis.Conclusions: For the prevention of congenital syphilis, anti-syphilis treatment during pregnancy for syphilis seropositive pregnant women is needed, regardless of whether the patient has received anti-syphilis treatment before pregnancy, especially for those patients with secondary syphilis or high baseline serum TRUST titer, thus, timely surveillance, early diagnosis to timely treatment, and close syphilis reexamination during posttreatment follow-up, may help to reduce the above-mentioned risk factors for congenital syphilis.
文摘目的 探讨甲苯胺红快速血浆反应素试验（TRUST）在梅毒传染性中的诊断价值和临床意义。 方法 收集酶联免疫吸附试验（ELISA）和梅毒螺旋体颗粒凝集试验（TPPA）试验均阳性的住院患者血清73例，再用TRUST试验和梅毒螺旋体IgM抗体蛋白印迹试验（TP-IgM）进行检测，采用SPSS 16.0软件建库统计指标计算与分析两种试验的结果。 结果 随着TRUST滴度的升高，TP-IgM的阳性率也升高，差异有统计学意义（H=7.267, P 〈0.05）。经两两比较，TRUST阴性与阳性组滴度〈1∶8的TP-IgM阴阳性没有统计学意义（H=0.141, P 〉0.05）；TRUST阴性与阳性组滴度≥1∶8的TP-IgM阴阳性有统计学意义（H=5.909, P 〈 0.05 ）；TRUST阳性组滴度〈1∶8与滴度≥1∶8的TP-IgM阴阳性有统计学意义（H=5.859, P 〈0.05）。TRUST、TP-IgM阴性组和阳性组（包括弱阳性、阳性和TRUST〈1∶8）一致性检验差（Kappa=0.011， P = 0.916 ），TRUST、TP-IgM阴性组（包括阴性、弱阳性和TRUST〈1∶8）和阳性组一致性检验差（Kappa= 0.006 ， P =0.951）。 结论 TRUST试验对梅毒传染性有较好的诊断价值，特别在滴度≥1∶8时，临床工作者更应该注意其传染性；对TRUST阴性和滴度〈1∶8时，TP-IgM是判断标本有无传染性的补充指标。
