219例妊娠梅毒患者与配偶的梅毒血清学临床研究  

A study on syphilitic serology in 219 pregnant women with syphilis and their spouses

作　　者：李湘辉[1] 张荣[1] 陈仲 鲁东平[1] 

机构地区：[1]深圳市宝安区慢性病防治院皮肤科,广东深圳518101 [2]深圳市福永人民医院皮肤科,广东深圳518103

出　　处：《中国艾滋病性病》2014年第6期434-436,共3页Chinese Journal of Aids & STD

摘　　要：目的了解妊娠梅毒患者与配偶的感染状况,为制定降低梅毒发病率相关政策提供依据。方法对219例妊娠梅毒患者的配偶进行甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶颗粒凝集试验（TPPA）检测,结果均阴性者,3个月后复查TRUST和TPPA。对妊娠梅毒患者与配偶的检测结果进行统计分析。结果 219例妊娠梅毒患者,TRUST滴度范围为1∶1-1∶256,TRUST滴度≥1∶16者45例,TRUST滴度〈1∶16者174例。1例合并HIV（＋）。3例为二期梅毒,其中2例夫妻同患二期梅毒,另1例配偶TRUST滴度为1∶16,无临床症状。53例配偶TRUST和TPPA均阳性。配偶TRUST滴度≥1∶16者18例,TRUST滴度〈1∶16者42例。7例配偶TRUST阴性,TPPA阳性,其中1例6周后复查TRUST转为阳性。妊娠梅毒患者TRUST滴度〈1∶16组的174名配偶,24.1%（42/174）为梅毒感染者;妊娠梅毒患者TRUST≥1∶16组的45名配偶,40.0%（18/45）为梅毒感染者,两组梅毒感染率差异有统计学意义（χ2=4.522,P〈0.05）。结论此次调查对象大多数为潜伏梅毒,开展妊娠梅毒的普查,对妊娠梅毒的配偶进行追踪检测,是降低梅毒发病率的有效方法。TPPA比TRUST更适合梅毒高危人群的筛查试验;TRUST滴度≥1∶16的妊娠梅毒的配偶,梅毒感染率高于滴度〈1∶16的妊娠梅毒配偶。Objective To understand the prevalence of syphilis in pregnant women and their spouses, and provide the basis for policymaking to reduce incidence of syphilis. Methods A total of 219 pregnant women with syphilis and their spouses without syphilis were involved in this study. They were followed up by toluidine red unheated serum test （TRUST） and treponema pallidum particle agglutination （TPPA） for 3 months. The results were analyzed statistically. Results Of 219 syphilis-infected pregnant women,TRUST titer ranged from 1 ： 1 to 1 ： 256, with 45 cases of TRUST≥I ： 16 and 174 cases of TRUST〈I ： 16. One case coinfected with human immunodeficiency viruses （HIV）. There were 3 cases of secondary pregnant syphilis, 2 couples and another spouse with TRUST titer 1 ： 16. They had no clinical symptoms. Among 219 spouses, 53 were positive for both TRUST and TPPA, and 7 TPPA positive only, of which 1 case was reexamined after six weeks and the TRUST turned positive. Of 174 couples whose wife TRUST titer ≥ 1 ： 16, 24.1% （42/174） were infected with syphilis. Of 45 couples whose wife TRUST titer 〈1 ： 16, 40.0% （18/45） were infected with syphilis. The syphilis infection rate of the two groups had a significant difference （x2=4. 522,P〈0.05）. Conclusions Most of syphilis patients are asymptomatic. It is an effective method to reduce incidence of syphilis by screening syphilis in pregnant women and following up spouses of positive ones. TPPA seems more suitable than TRUST to screen syphilis high risk population. The infection rate of the spouses whose wife TRUST≥1：16 is higher than that of TRUST〈1 ： 16.

关 键 词：梅毒 妊娠梅毒 配偶 血清学 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]