妊娠期梅毒流行特征和防治对策  

Epidemic characteristics and prevention strate⁃gies of syphilis during pregnancy

作　　者：梁轶珩[1] 樊尚荣[1] LIANG Yi-heng;FAN Shang-rong(Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院,广东深圳518036

出　　处：《中国实用妇科与产科杂志》2023年第12期1164-1167,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(82171676)。

摘　　要：在全球范围内,妊娠期梅毒的发病率呈上升趋势。在中国,随着降消项目的开展,先天梅毒发病率及围产儿死亡率明显下降。妊娠期梅毒感染的高危因素包括:多性伴侣、吸毒、文化程度中等、无业/待业。推荐所有孕妇在第1次就诊时采用梅毒血清学试验进行筛查,螺旋体试验和非螺旋体试验相互确诊。对螺旋体颗粒凝集试验(treponema pallidum particle agglutination assay,TPPA)阳性的孕妇予苄星青霉素240万U肌肉注射,1次/周,连续3周。梅毒感染孕产妇所分娩新生儿出生后取血筛查TPPA、甲苯胺红不加热血清试验(toluidine red unheated serum test,TRUST)及梅毒螺旋体IgM抗体,并予苄星青霉素5万U/kg肌注预防梅毒感染。The incidence of syphilis in pregnancy is on the rise globally.In China,with the implementation of the elimination programs,the incidence of congenital syphilis and perinatal mortality have decreased sig⁃nificantly.High-risk factors for syphilis infection during pregnancy include:multiple sexual partners,drug abuse,moderate educational level,and unem⁃ployment.It is recommended that all pregnant women be screened with a syphilis serology test at the first visit,with treponemal and non-treponemal tests mu⁃tually confirming the diagnosis.Three doses of peni⁃cillin G benzathine 2.4 million units for intramuscular injection one a week are recommended for pregnant women with positive treponema pallidum particle ag⁃glutination assay(TPPA).After birth,the blood of newborns born to syphilis-infected mothers is taken to screen for TPPA,toluidine red unheated serum test(TRUST)and treponema pallidum IgM antibodies,and penicillin G benzathine of 50000 U/kg intramuscularly is administered for preventing syphilis infection.

关 键 词：妊娠期梅毒 先天梅毒 流行特征 治疗 预防 筛查 

分 类 号：R714.251[医药卫生—妇产科学]