【摘要】 目的探讨不同干预孕周及孕母血清滴度对于妊娠合并隐性梅毒孕妇不良妊娠结局的影响。方法选择265例妊娠合并隐性梅毒患者,按抗梅毒治疗时机将233例治疗组患者分为<16周组、16~28周组和>28周组,32例未接受抗梅毒治疗的患者设为未治疗组,按孕母甲苯胺红不加热血清试验(TRUST)滴度又将患者分为低滴度组(<1:8)、中滴度组(1:8~1:16)和高滴度组(>1:16),比较不同干预孕周及不同滴度水平对不良妊娠结局的影响。结果妊娠结局比较,治疗组与未治疗组围产儿死亡发生率差异有统计学意义(P<0.05),胎窘、早产和先天梅毒的发生率有显著性差异(P<0.01)。妊娠<16周干预组中胎窘的发生率明显低于其他二组,差异有统计学意义(P<0.01),各治疗组间早产、先天梅毒和新生儿畸形的发生率比较差异无统计学意义(P>0.05)。不同滴度水平下围产儿死亡、先天梅毒的发生率差异有统计学意义(P<0.05)。结论妊娠期抗梅毒治疗可以改善不良妊娠结局,抗梅毒治疗越早,胎窘发生率越低,中晚期干预也能取得理想的母婴阻断效果;孕母血清滴度水平是影响先天梅毒和围产儿死亡发生的重要因素。更多还原

【Abstract】 Objective To study the influence of different gestations and TRUST titer intervention on adverse outcomesof patients with latent syphilis. Methods The 265 pregnancy patients with latent syphilis were divided into treatment group(233 patients) and non-treatment group(32 patients).According to the intervention time, 233 patients in the treatment groupduring the pregnancy were divided into three groups(<16 weeks,16~28weeks, >28weeks), Based on the TRUST titer, allpatients were divided into three groups(<1:8、1:8~1:16、>1:16). Adverse pregnancy outcomes were compared among differentgroups.Results Perinatal mortality in treatment group was lower significantly than non- treatment group(P<0.05), thedifference in the incidence of fetal distress, preterm birth and congenital syphilis between the treatment and the non-treatmentgroup was statistically significant(P<0.01). The rate of fetal distress in treatment group(<16 weeks gestation) was lowersignificantly than in the other groups(P<0.01). There was no significant difference in the incidence of preterm birth, perinataldeath, congenital syphilis and congenital malformation among the groups treat at different gestations trimes(P>0.05).Significant difference in congenital syphilis and perinatal death was found among the groups of different TRUST titer(P<0.05).Conclusions Anti-syphilis therapy during pregnancy can improve the perinatal outcomes. Earlier treatment may reduce therate of fetal distress, and treatment at midterm or late gestations might also achieve the ideal results of interruping thetransmission from mothers to the fetus. Maternal serum TRUST titer is an important factor inluencing congenital syphilis andperinatal death.更多还原