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目的探讨妊娠合并梅毒患者孕期干预治疗及梅毒血清学检测结果与发生先天梅毒的关系,为先天梅毒的干预及评估提供依据。方法将427例已分娩的妊娠梅毒产妇按干预治疗(319例)和未干预治疗(108例)分两组,比较二者先天梅毒发生情况;对产妇及其所生新生儿TRUST滴度进行随访18个月并比较分析。结果未干预组先天梅毒发生率为16.8%(18/106),干预组先天梅毒发生率为0(0/319)。母亲生产时TRUST滴度与新生梅毒儿出生时TRUST滴度呈正相关(Kendall相关系数为0.4,P<0.05);先天梅毒儿出生时滴度的高低与其是否有典型的先天梅毒临床表现相关,且先天梅毒儿出生时TRUST滴度≥1:32时,更易出现具有皮肤粘膜损害、黄疸、蛙状腹等临床症状(Fisher确切概率法,P=0.000);而母亲梅毒分期与是否有典型的先天梅毒临床表现无关(Fisher确切概率法,P>0.05)。结论妊娠梅毒的筛查和干预治疗可有效阻断先天梅毒的传播,应高度关注疑似先天梅毒儿血清TRUST滴度继续升高的情况,将TRUST滴度≥1:32作为重要的监测指标。
Objective To investigate the relationship between the pregnancy interventional therapy and the results of syphilis serology and the occurrence of congenital syphilis in pregnant women with syphilis and to provide basis for the intervention and assessment of congenital syphilis. Methods 427 pregnant women with gestational syphilis who had given birth were divided into two groups according to the intervention (319 cases) and no intervention (108 cases). The incidence of congenital syphilis was compared between the two groups. The TRUST titer of the pregnant women and their newborn infants was followed up 18 months and comparative analysis. Results The incidence of congenital syphilis in non-intervention group was 16.8% (18/106), and the incidence of congenital syphilis in intervention group was 0 (0/319). The TRUST titer at birth was positively correlated with the TRUST titer at birth (Kendall correlation coefficient of 0.4, P <0.05). The birth titers of congenital syphilis were correlated with the clinical manifestations of congenital syphilis and Congenital syphilis at birth TRUST titers ≥ 1: 32, the more prone to skin mucosal damage, jaundice, frog belly and other clinical symptoms (Fisher exact probability method, P = 0.000); and the mother of syphilis staging and whether there is a typical congenital Syphilis has nothing to do with the clinical manifestations (Fisher exact probability method, P> 0.05). Conclusion Pregnancy syphilis screening and intervention treatment can effectively prevent the transmission of congenital syphilis, should pay close attention to suspected cases of congenital syphilis serum TRUST titers continue to rise, the TRUST titer ≥ 1: 32 as an important monitoring indicators.