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目的:探讨快速血浆反应素(RPR)高滴度(≥1:16)的妊娠梅毒患者治疗后的妊娠结局,以便选择更好的治疗时机与方案。方法:根据孕妇孕周,将116例妊娠梅毒患者分为3组,即早孕组(63例),中孕组(36例)和晚孕组(17例)。各组均予规范苄星青霉素驱梅治疗,比较3组患者治疗后的妊娠结局。结果:63例早孕组患者接受治疗后未发生先天梅毒、早产、死胎、低体重儿及新生儿死亡;36例中孕组患者经治疗后未发生先天梅毒、早产、低体重儿及新生儿死亡,出现死胎1例,死胎发生率2.78%;17例晚孕组患者接受治疗后未发生先天梅毒、早产、低体重儿及新生儿死亡,出现死胎2例,死胎发生率11.76%;早孕组与中孕组妊娠结局相比,差异无统计学意义(P>0.05);晚孕组死胎率明显高于早、中孕两组,妊娠结局与前两组比较差异有统计学意义(P<0.05)。结论:尽早对孕妇行产前梅毒筛查并积极治疗,即使是RPR高滴度患者也可得到理想的治疗结果,能很好地改善不良妊娠结局。
OBJECTIVE: To investigate the pregnancy outcomes of pregnant women with high titer (≥1: 16) of rapid plasma reactive protein (RPR) after treatment in order to choose a better timing and scheme of treatment. Methods: According to gestational age of pregnant women, 116 pregnant women with syphilis were divided into 3 groups: early pregnancy group (63 cases), middle pregnancy group (36 cases) and late pregnancy group (17 cases). All groups were given standard benzathine penicillin treatment plum, the treatment group compared the outcome of pregnancy. Results: No congenital syphilis, premature birth, stillbirth, low birth weight infants and newborn infants died in 63 early pregnancy groups. No congenital syphilis, preterm birth, low birth weight infants and neonates died after treatment , One case of stillbirth and 2.78% of stillbirth occurred; 17 cases of late pregnancy group had no congenital syphilis, no premature syphilis, low birth weight and neonatal death, 2 cases of stillbirth and 11.76% of stillbirth; There was no significant difference in pregnancy outcomes between the two groups (P> 0.05). The rate of stillbirths in late pregnancy group was significantly higher than that in early pregnancy group and middle pregnancy group (P <0.05) ). Conclusion: As early as possible, prenatal syphilis screening and active treatment of pregnant women, even in patients with high RPR titer can be the ideal treatment results, can well improve adverse pregnancy outcomes.