头孢曲松钠联合苄星青霉素治疗晚期妊娠合并潜伏梅毒的临床分析  

Clinical Analysis of Ceftriaxone Sodium Combined with Benzathine Penicillin in the Treatment of Late Pregnancy with Latent Syphilis

作　　者：李双凤 闫宁[2] 陈斌[3] 于晓云[2] 王伟 马超 Li Shuangfeng;Yan Ning;Chen Bin;Yu Xiaoyun;Wang Wei;Ma Chao(Fuyang People's Hospital,Fuyang 236000,China;The Second Hospital of Nanjing,Nanjing 210003,China;The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]安徽省阜阳市人民医院,安徽阜阳236000 [2]南京市第二医院,江苏南京210003 [3]南京医科大学第一附属医院,江苏南京210029

出　　处：《中国中西医结合皮肤性病学杂志》2022年第3期215-218,共4页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

摘　　要：目的探讨头孢曲松钠联合苄星青霉素治疗晚期妊娠合并潜伏梅毒的梅毒血清学变化及妊娠结局。方法回顾性分析2016年9月—2018年1月于阜阳市人民医院确诊的95例首诊晚期妊娠合并潜伏梅毒患者为研究对象,根据给药不同分为观察组(52例)和对照组(43例),其中观察组给予头孢曲松钠联合苄星青霉素治疗,对照组给予单一苄星青霉素治疗,对比2组患者治疗后第3、6、9、12、18个月血清中梅毒甲苯胺红不加热血清试验(Trust)的变化和妊娠结局,以及随访至生产后18个月的梅毒螺旋体颗粒凝集试验(TPPA)和Trust的转归和新生儿出生时阿普加(Apgar)评分。结果患者治疗后随访至第9、12个月时,观察组转阴率显著高于对照组(分别为51.92%vs.30.23%,P=0.033;57.69%vs.37.21%,P=0.047);新生儿梅毒血清学在各个时段的转阴率相比差异无统计学意义(均P>0.05);对照组相比,观察组新生儿不良结局例数较少,但差异无统计学意义(5例vs.8例,P=0.184);观察组新生儿Apgar评分1 min评分分数明显高于对照组(9.37 vs.9.02,P=0.004),差异有统计学意义。结论头孢曲松钠联合苄星青霉素治疗晚期妊娠合并潜伏梅毒效果优于苄星青霉素,前者的血清Trust转为阴性的速率加快,转为阴性的比率增高。Objective In order to investigate the serological changes and pregnancy outcome of ceftriaxone sodium combined with benzathine penicillin in the treatment of late pregnancy with latent syphilis.Methods Retrospective analysis was performed on 95 cases of first-diagnosed late-pregnancy patients with latent syphilis diagnosed from September 2016 to January 2018.According to different treatment regimens,the patients were divided into observation group(52 cases)and control group(43 cases).The observation group were treated with ceftriaxone sodium and benzathine penicillin,while the control group were treated with benzathine penicillin alone.The changes and pregnancy outcomes of toluidine red unheated serum test(Trust)at 3,6,9,12 and 18 months after the treatment were compared between the two groups,as well as the outcomes of treponema pallidum particle agglutination test(TPPA)and Trust after follow-up up to 18 months and the Apgar score at birth.Results When the patients were followed up to 9 and 12 months after the treatment,the negative conversion rate in the observation group was significantly higher than that in the control group(51.92%vs.30.23%,P=0.033;57.69%vs.37.21%,P=0.047,respectively).There were no statistically significant differences in the conversion rate of neonatal syphilis serology in each period(all P>0.05).Compared with the control group,there were less cases of adverse outcomes in the observation group,but the differences were not statistically significant(5 cases vs.8 cases,P=0.184).The Apgar score in the observation group was significantly higher than that in the control group,and the differences were statistically significant(9.37 vs.9.02,P=0.004).Conclusion The efficacy of ceftriaxone sodium combined with benzathine penicillin in the treatment of late pregnancy with latent syphilis was better than that of benzathine penicillin.In the former,the rate of serum Trust turning negative is accelerated,and the rate of turning negative is increased.

关 键 词：头孢曲松钠 苄星青霉素 梅毒甲苯胺红不加热血清试验滴度 晚期妊娠合并潜伏梅毒 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]