对孕产妇进行梅毒血清学检查的临床价值分析

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目的探讨对孕产妇进行梅毒血清学临床检查的价值,以及对胎儿健康的影响。方法 2218例产检孕妇,均给予梅毒血清学检查。对确诊梅毒孕妇进行随访,记录其妊娠结局情况,并与健康产妇进行比较。结果采用梅毒螺旋体明胶颗粒凝集试验(TPPA)法检测发现,2218例孕妇中,39例孕妇显示抗-梅毒螺旋体(TP)阳性,阳性率为1.76%;采用酶联免疫吸附试验(ELISA)法复查,39例抗-TP阳性孕妇均为阳性,符合率为100.00%;采用甲苯胺红不加热血清试验(TRUST)法复查,27例抗-TP阳性孕妇为阳性,符合率为69.23%。合并梅毒孕妇成功分娩率为71.79%,低于健康孕妇的96.15%,合并梅毒孕妇死胎率为5.13%、流产率为7.69%、死产率为7.69%、早产率为7.69%,均高于健康孕妇的0.55%、1.70%、0.46%、1.15%,差异均具有统计学意义(χ~2=55.414、12.800、7.774、34.404、13.168,P<0.01)。结论对孕产妇进行梅毒血清学检查,是减少先天性梅毒、提高生育质量的有效途径,有利于降低梅毒感染可能导致的不良妊娠结局发生,值得临床推广应用。 Objective To investigate the value of maternal syphilis serology for clinical examination and the impact on fetal health. Methods 2218 pregnant women, were given syphilis serology. The confirmed syphilis pregnant women were followed up, record the pregnancy outcome, and compared with healthy mothers. Results The results of TPPA assay showed that among 2218 pregnant women, 39 pregnant women showed positive anti-Treponema pallidum (TP) positive rate of 1.76%. ELISA was used to examine the positive rate of anti-Treponema pallidum (TP) , 39 cases of anti-TP positive pregnant women were positive, the coincidence rate was 100.00%; using toluidine red unheated serum test (TRUST) method review, 27 cases of anti-TP positive pregnant women were positive, the coincidence rate was 69.23%. The successful delivery rate of pregnant women with syphilis was 71.79%, lower than 96.15% of healthy pregnant women. The stillbirth rate of pregnant women with syphilis was 5.13%, the abortion rate was 7.69%, the stillbirth rate was 7.69% and the preterm birth rate was 7.69% The difference of 0.55%, 1.70%, 0.46% and 1.15% in pregnant women was statistically significant (χ ~ 2 = 55.414,12.800,7.774,34.404,13.168, P <0.01). Conclusion It is an effective way to reduce the congenital syphilis and improve the reproductive quality of syphilis among pregnant women. It is helpful to reduce the adverse pregnancy outcome that the syphilis infection may cause. It is worthy of clinical application.
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