藥物治療對妊娠合并梅毒患者妊娠結局的影響分析

王蘭芳 林娟 王小敏 吉貞料

【摘要】目的：探討藥物治療對妊娠合并梅毒患者妊娠結局的影響，從而探尋降低新生兒梅毒發病率以及減少妊娠不良結局的臨床醫學辦法。方法：選擇2012年2月至2015年5月我院接診的妊娠合并梅毒80例患者進行研究。隨機分為觀察、對照組各40例，對照組不實施任何治療，觀察組實施全過程的抗霉素治療措施，對比分析兩組患者的妊娠結局、新生兒情況、患者血清RPR滴度、治療孕周與新生兒梅毒之間的關系。結果：觀察組患足月產38例，占95.00%，對照組足月產10例，占25.00%，觀察組早產、流產、死亡的發生率要明顯低于對照組，并且觀察組沒有死亡和流產的情況發生，兩組患者妊娠結局比較，差異具有統計學意義（P<0.05）；觀察組正常新生兒有35例，占87.50%，對照組僅7例，占17.50%，而兩組患者正常新生兒比較，差異具有統計學意義（χ2=12.9210， P=0.0003）；觀察組在先天梅毒兒、窒息兒、低體質量兒等要明顯低于對照組（P<0.05）；患者血清RPR滴度與新生兒預后的關系分析：患者血清RPR滴度≥1∶16的新生兒預后明顯沒有患者血清RPR滴度≤1∶8的好，兩組患者血清RPR滴度與新生兒預后的比較，差異具有統計學意義（P<0.05）；選擇越早的治療孕周，其先天梅毒兒的發生也就越小，不同治療時間的梅毒產婦產出正常新生兒比例比較，差異具有統計學意義（P<0.05）。結論：妊娠合并梅毒的孕產婦極易出現不良的妊娠結局，對妊娠合并梅毒感染患者進行血清學檢查尤為重要，及時有效地對妊娠合并梅毒感染患者采取規范化的抗梅治療，能夠降低新生兒先天梅毒的發生，有效減少妊娠不良結局的發生。

【關鍵詞】妊娠；梅毒；血清學檢測；妊娠結局

Effect of drug therapy on the pregnancy outcomes of pregnant patients with syphilisWANG Lanfang1， LIN Juan2， WANG Xiaomin1， JI Zhenliao3. 1.Clinical Laboratory Department， Haikou City Traditional Chinese Medical Hospital， Haikou 570203， Hainan， China； 2.Clinical Laboratory Department， Hainan Province Traditional Chinese Medical Hospital， Haikou 570203， Hainan， China；3.Traditional Chinese Medical Rehabilitation Department， Hainan province Nongken Total Hospital， Haikou 570311， China

【Abstract】Objectives： To study the effect of syphilis serology testing on pregnancy outcome， thereby seeking clinical approaches to reduce the incidence of neonatal syphilis and reduce adverse pregnancy outcomes. Methods： 80 pregnant patients with syphilis in our hospital from February 2012 to May 2015 were selected and randomly divided into observation group and control group， each of 40 cases. The control group did not receive any treatment， while the observation group was given whole process of antimycin treatment. The pregnancy outcomes， newborns， serum RPR， therapeutic relationship between gestational age and neonatal syphilis of the two groups were compared. Results： There were 38 （95.00%） cases and 10 （25.00%） cases of full-term birth in the observation group and control group respectively. The incidence of premature birth， abortion and death in the observation group was significantly lower than the control group， with statistically significant difference in pregnancy outcomes （P<0.05）. There were 35 （87.50） and 7 （17.50%） normal newborns in observation and control group respectively， with statistically significant difference （χ2=12.9210， P=0.0003）. The number of newborns with congenital syphilis， asphyxia and low body weight in observation group was significantly lower than the control group， with statistically significant difference （P<0.05）. According to the relationship between serum RPR titers and neonatal prognosis： for patients with serum RPR titer ≥1∶16， the neonatal outcomes significantly worse than those with serum RPR titers ≤1∶8， with statistically significant difference （P<0.05）. For patients with earlier treatment gestational age， the incidence of congenital syphilis was smaller： for those <16 weeks， there were normal newborns and those > 16 weeks， the newborns were with congenital syphilis， with statistically significant difference （P<0.05）. Conclusions： Pregnant women with syphilis are prone to adverse pregnancy outcomes， so the serological test is particularly important. Standardized anti-plum treatment for syphilis patients can reduce neonatal birth with syphilis and reduce adverse pregnancy outcomes.

【Key words】Pregnancy； Syphilis； Serological test； Pregnancy outcomes

【中圖分類號】R759.1+5【文獻標志碼】A

梅毒是一種有著高度傳播速度的傳染性疾病[1]。孕產婦在妊娠期的梅毒螺旋體可以通過胎盤造成胎兒宮內感染，從而導致死胎、早產、流產或分娩先天梅毒兒[2]。近年來，由于梅毒發病率正在逐漸地攀升，并且在這些患者中年婦女所占的比重越來越大，加上早期梅毒為較多數，這就加大了宮內胎傳的危險系數，嚴重影響了我國優生優育的生育政策[3]。為此我院對80例我院接診的妊娠合并梅毒感染患者進行研究，現報道如下。

1材料與方法

1.1一般資料

隨機選擇法選擇2012年2月至2015年5月我院接診的妊娠合并梅毒80例患者進行研究。80例病患都在知悉本次研究的目的后，自愿參加本次研究。……