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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。
Objective To investigate the influence of different intervention gestational weeks and serum concentrations of pregnant women on adverse pregnancy outcome in pregnant women with latent syphilis. Methods A total of 265 pregnant women with latent syphilis were selected. According to the timing of anti-syphilis treatment, 233 patients in treatment group were divided into 16 weeks group, 16-28 weeks group and 28 weeks group, and 32 patients who did not receive anti-syphilis treatment In the untreated group, the patients were divided into low titers (<1: 8), middle titers (1: 8 to 1:16) according to TRUST titers High titer group (> 1:16), compared different intervention gestational weeks and different titer levels on adverse pregnancy outcomes. Results Compared with the pregnancy outcome, there was a significant difference in the incidence of perinatal death between the treated and untreated groups (P <0.05). The incidence of fetal distress, premature birth and congenital syphilis were significantly different (P <0.01). The incidence of fetal embarrassment in the intervention group <16 weeks was significantly lower than that in the other two groups (P <0.01). There was no significant difference in the incidence of preterm birth, congenital syphilis and neonatal malformation among the treatment groups Significance (P> 0.05). There were significant differences in the incidence of congenital syphilis between perinatal mortality and different titers (P <0.05). Conclusion Pregnancy anti-syphilis treatment can improve the outcome of adverse pregnancy, the sooner anti-syphilis treatment, the lower the incidence of fetal distress, middle and late intervention can achieve the desired maternal and child block effect; maternal serum titer is the impact of congenital syphilis and An important factor in perinatal death.