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目的分析梅毒母婴传播资料,为先天梅毒诊断提供依据。方法采用随机抽样法,选取2009年1月—2011年3月在湖州市妇幼保健院产科门诊体检的梅毒阳性孕妇52例,其中梅毒孕妇分娩的新生儿47人,在出生和1、3、6、9、12、18月龄时进行快速血浆反应素环状卡片试验(RPR)、梅毒螺旋体明胶凝集试验(TPPA)血清学监测和随访,同时对母亲进行血清学随访。结果 47名新生儿中,出生时46人TPPA阳性;28人RPR阳性,滴度从1∶1到1∶256不等;出生时确诊先天梅毒2例,3月时确诊1例,所有未感染儿童RPR均在3月龄内转阴。44名婴儿随访后均排除梅毒感染,RPR阴转时间明显早于TPPA阴转时间。所有梅毒产妇及2例先天梅毒患儿TPPA持续阳性。结论梅毒孕妇分娩的未感染梅毒婴儿RPR在3月龄内转阴,TPPA在12月龄内转阴;对梅毒孕妇所生的婴儿需要随访至少一年。
Objective To analyze the information of mother-to-child transmission of syphilis and provide evidence for the diagnosis of congenital syphilis. Methods A total of 52 pregnant women with syphilis from January 2009 to March 2011 in obstetrics and gynecology clinic of Huzhou Maternal and Child Health Hospital were selected. Among them, 47 were neonates with syphilis and were born at 1,3,6 The RPR and TPPA serological surveillance and follow-up were performed at 9, 12, and 18 months of age. The mothers were followed up serologically. Results Of the 47 newborn infants, 46 were positive for TPPA at birth; 28 were RPR positive with titer ranging from 1: 1 to 1: 256; 2 were diagnosed with congenital syphilis at birth, 1 was diagnosed at 3 months, and all were uninfected Children RPR are negative in 3 months. Twenty-four infants were excluded from syphilis infection after follow-up, and the RPR negative conversion time was significantly earlier than the TPPA negative conversion time. TPPA in all syphilis mothers and 2 cases of congenital syphilis continued to be positive. Conclusions The RPR of uninfected syphilis infants born in syphilis pregnant women is negative within 3 months and TPPA is negative within 12 months of age. The infants born to syphilis pregnant women need to be followed up for at least one year.