先天梅毒危险因素分析  

Analysis of risk factors of congenital syphilis

作　　者：黄喜明[1] 潘鹏[2] 

机构地区：[1]佛山市南海区疾病预防控制中心,广东佛山528200 [2]深圳市慢性病防治院,广东深圳518020

出　　处：《中国热带医学》2014年第4期476-478,共3页China Tropical Medicine

摘　　要：目的探讨先天梅毒发生的危险因素,为梅毒母婴传播控制策略提供参考。方法回顾性收集2002年7月~2004年12月所建立的梅毒孕妇及其子女临床病历资料,对确诊梅毒的母婴临床资料进行分析,首先对调查得出的变量进行因子分析,构造出潜在外生因子及潜在内生因子,其次用线性结构方程LISEREL分析潜在外生因子与潜在内生因子之间的关系,并对模型进行拟合和评价。结果母亲年龄和孕次对先天梅毒的影响效应最大,总效应为-0.4055;首次产检孕周、孕期抗梅毒治疗情况等就医行为直接影响先天梅毒的发生,直接效应为-0.1892;父母文化、职业以及婚姻状况对先天梅毒无直接效应,但通过母亲就医行为间接影响先天梅毒的发生,间接效应为-0.0689。结论母亲首次产检孕周、妊娠期内抗梅毒治疗和母亲年龄、孕次是影响婴儿先天梅毒发生的直接因素,提高孕妇人群的产前保健率,尤其是孕早期产前保健率,可早发现、早治疗,减少先天梅毒的发生,是提高先天梅毒防治效果的关键。Objective To discuss the risk factors of congenital syphilis and provide the basis for maternal childtransmission Prevention. Methods The 376 cases of maternal child transmission of syphilis from July 2002 to December2004 were collected and retrospectively analyzed. The potential exogenous factors and potential endogenous factors wereestablished by analysis of the variables and the relationships between them were analyzed with linear structural equationLISEREL, followed by fitting and evaluating the model. Results The greatest factor influencing the congenital syphilis wasmother age and gravidity with total effect of-0.4055. Health seeking behavior such as the first clinical prenatal gestational age,syphilis treatment situation during pregnancy directly impacted the incidence of congenital syphilis with direct effect value（0.1892）. Parents educational level, profession and marriage had no direct impact on congenital syphilis,but medical careseeking behaviors of mothers indirectly influenced the incidence of congenital syphilis with indirect effect（- 0.0689）. Conclusion The first clinical gestational age of mothers, syphilis treatment situation during pregnancy, and mothers age,pregnant times were the direct factors affected infants congenital syphilis. Prenatal care in pregnant women, especially in theearly stage is the key to improve prevention and control of congenital syphilis.

关 键 词：先天梅毒 危险因素 抗梅毒治疗 因子分析 母亲年龄 线性结构方程 母婴传播 临床资料 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]