妊娠对梅毒抗体滴度表达的影响及治疗时机研究  

Impact of pregnancy on expression of syphilis antibody titer and research on treatment timing

作　　者：马银芬[1] 陈卫红[1] 夏伟仁[2] 

机构地区：[1]浙江省绍兴第二医院妇产科,312000 [2]浙江省绍兴第二医院检验科,312000

出　　处：《中华全科医学》2015年第5期771-773,共3页Chinese Journal of General Practice

摘　　要：目的观察分析228例妊娠合并梅毒患者妊娠前、中、后梅毒抗体滴度变化及不良妊娠结局的发生率,以探讨妊娠合并梅毒患者妊娠期驱梅治疗时机。方法回顾性分析228例经驱梅规范治疗的妊娠并梅毒患者资料。根据孕期驱梅治疗时机分为4组:A组42例,孕期未给予驱梅治疗;B组51例,孕早期(12周内)给予驱梅治疗;C组58例,孕晚期(28周后)给予驱梅治疗;D组77例,全程给予驱梅治疗。对4组妊娠前、中、后TRUST滴度变化及不良妊娠结局发生率进行比较。结果妊娠前,4组梅毒抗体滴度均控制在1∶4之内,且各组间抗体滴度差异无统计学意义(P>0.05)。妊娠12周时,4组梅毒抗体滴度比明显升高(P<0.05);且A组和C组高梅毒抗体滴度比分布明显大于B组和D组(P<0.05)。分娩时,4组梅毒抗体滴度比值均有一定程度增大,A组梅毒抗体滴度比值明显高于B组、C组和D组(P<0.05)。分娩3个月时,4组梅毒抗体滴度比值均降低(P<0.05);且4组梅毒滴度比较差异无统计学意义(P>0.05)。A组不良妊娠结局发生率明显高于B组、C组和D组(P<0.05);治疗越早,不良妊娠结局发生率越低。结论妊娠可显著提高梅毒患者梅毒抗体滴度,妊娠结束后抗体滴度会自行下降。妊娠后,尽早给予规范驱梅治疗可有效降低不良妊娠结局的发生率。Objective To observe the syphilis antibody titers changes in gestational period and the incidence of adverse pregnancy outcomes,explore the syphilis treatment timing for syphilis patients in gestational period. Methods 228 cases of pregnancy combined syphilis were respectively analyzed. Based on the treatment timing,patients were divided into four groups： 42 cases patients in group A were not given anti-syphilitic treatment; 51 cases patients in group B were given antisyphilitic treatment at early pregnancy（ before 12 weeks）; 58 cases in group C were given anti-syphilitic treatment at late pregnancy（ after 28 weeks）,77 cases in group D were given anti-syphilitic treatment during the whole pregnancy. The TRUST titer at time before pregnancy,pregnancy,after pregnancy and adverse pregnancy outcomes rate of four groups were observed and compared. Results Before pregnancy,TRUST titer of four groups were all controlled under 1 ∶ 4,and the differences were not statistically significant（ P〉0. 05）. At pregnancy 12 weeks,the TRUST titer of four groups were significantly increased,and TRUST titer of group A and group C were significantly higher than group B and group D（ P〈0. 05）. At childbirth,the TRUST titer of four groups were significantly increased,and TRUST titer of group A was significantly higher than group B,group C and group D（ P〈0. 05）. After childbirth 3 months,the TRUST titer of four groups were significantly reduced,and the differences were not statistically significant（ P〉0. 05）. The adverse pregnancy outcomes rate of group A was significantly higher than group B,group C and group D（ P〈0. 05）,and earlier treatment lower adverse pregnancy outcomes rate（ P〈0. 05）. Conclusion Pregnancy can significantly increase the syphilis syphilis antibody titers,and the syphilis syphilis antibody titers itself decline after childbirth. After pregnancy,early standardized antisyphilitic treatment can effectively reduce the adverse pregnancy outcomes rate.

关 键 词：梅毒 妊娠 驱梅治疗 TRUST滴度 

分 类 号：R714[医药卫生—妇产科学] R759.1[医药卫生—临床医学]