深圳市福田区921例妊娠梅毒干预效果分析  

Analysis on interventional effect of pregnant syphilis in 921 cases in Futian district of Shenzhen city

作　　者：朱红[1] 许宗严[1] 邱莉霞[1] 向莹君[1] 李频[1] 帅俊[1] 郑铁洪[1] 赵蓉[1] 宋平[1] 

机构地区：[1]广东省深圳市福田区慢性病防治院皮肤性病防治科,518048

出　　处：《中国妇幼保健》2013年第22期3577-3579,共3页Maternal and Child Health Care of China

摘　　要：目的:分析对深圳市福田区921例妊娠梅毒干预效果,为进一步制定预防与控制梅毒母婴传播项目策略提供依据。方法:对921例妊娠梅毒患者依据注射苄星青霉素的时间分为早期干预组(<孕28周)、晚期干预组(孕28～35周)及未干预/不完整干预组,并依据妊娠梅毒患者甲苯胺红不加热血清试验(TRUST)滴度水平分为低滴度组(≤1∶4)、中滴度组(1∶8～1∶16)及高滴度组(>1∶16),研究相同干预时机不同血清TRUST水平对患者妊娠结局的影响,以及相同滴度水平下不同干预时机对患者妊娠结局的影响。结果:665例接受规范治疗干预患者未发生先天梅毒、早产及新生儿死亡;256例未干预/不完整干预患者先天梅毒、早产、低体重出生儿、新生儿死亡及死胎发生率分别为3.13%、3.91%、6.25%、1.56%、9.38%。患者在早期(<28周)或晚期(28～35周)接受规范干预均能够获得满意的干预效果,未干预/不完整干预者不良妊娠结局发生率高于规范干预者(P<0.05);未干预/不完整干预妊娠梅毒患者发生不良结局的危险性与血清滴度水平有关(P<0.05)。结论:规范长效青霉素治疗能使妊娠梅毒患者避免发生不良妊娠结局,即使在孕28～35周接受规范干预仍能获得理想效果。妊娠梅毒患者发生先天梅毒儿、早产、死胎及新生儿死亡的危险性与血清TRUST滴度水平相关。Objective： To analyze the interventional effect of pregnant syphilis in 921 cases in Futian district of Shenzhen city,and provide a basis for further making prevention and control strategies of syphilis maternal-infantile transmission project.Methods： A total of 921 patients with pregnant syphilis were divided into early intervention group（ 28 gestational weeks）,late intervention group（28-35 gestational weeks） and non-intervention / incomplete intervention group according to the injection time of benzathine benzylpenicillin,at the same time,the patients were divided into low-titer group（≤41） ∶,moderate-titer group（8 1-∶1 16∶） and high-titer group（1 16∶） according to toluidine red unheated serum test（TRUST）;the effects of different serum TRUST levels on pregnancy outcome on the circumstance of the same intervention time and the effects of different intervention times on the circumstance of the same titer were studied.Results： No congenital syphilis,premature birth and neonatal death occurred among 665 patients receiving standardized treatment and intervention;while among 256 patients not receiving intervention or receiving incomplete intervention,the incidence rates of congenital syphilis,premature birth,low birth weight infants,neonatal death and stillbirth were 3.13%,3.91%,6.25%,1.56% and 9.38%,respectively.Satisfactory interventional effects were obtained among the patients receiving standardized intervention before 28 gestational weeks and during 28-35 gestational weeks,the incidence rate of adverse pregnancy outcome in patients not receiving intervention or receiving incomplete intervention was statistically significantly higher than that in patients receiving standardized intervention（P 0.05）;the risk of pregnancy outcome in patients not receiving intervention or receiving incomplete intervention was correlated with serum titer level（P 0.05）.Conclusion： Standardized and long-term penicillin treatment can avoid adverse pregnancy outcome among patients with pre

关 键 词：妊娠梅毒 母婴传播 干预 

分 类 号：R173[医药卫生—妇幼卫生保健]