妊娠梅毒与先天梅毒相关性分析  

Correlation of pregnant syphilis with congenital syphilis

作　　者：李真 田丽闪 罗珍胄 周国茂 袁军 杨祖庆 

机构地区：[1]深圳市南山区慢性病防治院,广东深圳518054

出　　处：《中国热带医学》2011年第11期1383-1385,共3页China Tropical Medicine

摘　　要：目的探讨妊娠合并梅毒患者孕期干预治疗及梅毒血清学检测结果与发生先天梅毒的关系,为先天梅毒的干预及评估提供依据。方法将427例已分娩的妊娠梅毒产妇按干预治疗(319例)和未干预治疗(108例)分两组,比较二者先天梅毒发生情况;对产妇及其所生新生儿TRUST滴度进行随访18个月并比较分析。结果未干预组先天梅毒发生率为16.8%(18/106),干预组先天梅毒发生率为0(0/319)。母亲生产时TRUST滴度与新生梅毒儿出生时TRUST滴度呈正相关(Kendall相关系数为0.4,P<0.05);先天梅毒儿出生时滴度的高低与其是否有典型的先天梅毒临床表现相关,且先天梅毒儿出生时TRUST滴度≥1:32时,更易出现具有皮肤粘膜损害、黄疸、蛙状腹等临床症状(Fisher确切概率法,P=0.000);而母亲梅毒分期与是否有典型的先天梅毒临床表现无关(Fisher确切概率法,P>0.05)。结论妊娠梅毒的筛查和干预治疗可有效阻断先天梅毒的传播,应高度关注疑似先天梅毒儿血清TRUST滴度继续升高的情况,将TRUST滴度≥1:32作为重要的监测指标。Objective To investigate the correlation of anti-syphilis therapy and serological test results with incidence of neonatal congenital syphilis in pregnant syphilis patients.Methods 427 pregnant syphilis patients were respectively divided into intervention treatment group（319 cases） and control group（108 cases）,and the incidence of neonatal congenital syphilis between two groups were compared.TRUST serum titer of all the mothers and their neonates were followed up until the age of 18 months.Results The incidence of neonatal congenital syphilis in control group and intervention group were 16.8%（18/106）and 0（0/319）.TRUST serum titer of the mothers was positively correlated with the newborns with congenital syphilis（Kendall correlation coefficient was 0.4,P0.05）.The TRUST serum titer of newborns with congenital syphilis were related to symptoms appeared.Symptom like skin and mucous membrane,jaundice and frog belly were more likely to appeared when TRUST serum titer≥1：32（Fisher Exact Test,P =0.000）;and the mothers＇ stage of syphilis was not correlated with the clinical symptoms of congenital syphilis（Fisher Exact Test P0.05）.Conclusion The screening and anti-syphilis treatment of pregnant women can effectively interrupt the transmission of congenital syphilis in the newborns and TRUST serum titer≥1：32 can be used as an important monitoring indicator.

关 键 词：梅毒 妊娠 先天梅毒 

分 类 号：R759.15[医药卫生—皮肤病学与性病学]