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李频,郑铁洪,许宗严,朱红,帅俊,梁远飞,邱莉霞.疑似先天梅毒儿梅毒血清学变化情况分析[J].中国医药科学,2019,(15):204-207        基金项目:
疑似先天梅毒儿梅毒血清学变化情况分析
Analysis on syphilis serological changes in suspected congenital syphilis
  
DOI:
中文关键词:  妊娠梅毒;疑似先天梅毒;抗心磷脂抗体 ;梅毒螺旋体抗体
英文关键词:Pregnant syphilis; Suspectedcongenital syphilis; Anti-cardiolipin antibody; Treponema pallidum antibody
作者单位
李频,郑铁洪,许宗严,朱红,帅俊,梁远飞,邱莉霞 深圳市福田区慢性病防治院,广东深圳 518048 
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中文摘要:
      [摘要] 目的 观察早期妊娠梅毒在经过正规驱梅疗后,其分娩的疑似先天梅毒儿的梅毒血清学变化规律,为先天梅毒的诊疗和预防提供流行病学依据。方法 选择 2012 ~ 2017 年在我院确诊的妊娠梅毒患者在孕早期(孕 20 周内)给予苄星青霉素规范治疗后,观察其分娩的疑似先天梅毒儿出生后的血清抗心磷脂抗体(RPR)、梅毒螺旋体抗体(TPPA)变化情况。其中 TPPA 和(或)RPR 阳性的新生儿,每隔三个月复查 1次 RPR(定性 + 定量)和 TPPA(定性),直至两者均转阴,否则最长复查至出生后 18 个月。对收集到的数据进行分组统计,并用统计学方法进行分析和处理。结果 收集到符合研究纳入标准的疑似先天梅毒病例227 例,其中男 123 例,女 104 例;平均出生孕周为(38.70±1.56)周;RPR 和 TPPA 均转阴的平均月份为(7.19±3.14)个月;疑似先天梅毒儿 RPR 检测≤ 1 个月阴转率为 48.02%,≤ 6 个月阴转率为 88.99%,≤ 12个月阴转率 100%;TPPA 阴转时间≤ 1 个月阴转率为 1.32%,≤ 6 个月阴转率为 62.56%,≤ 12 个月阴转率为 99.12%,≤ 18 个月阴转率 100%;母亲分娩前 1 个月 RPR 滴度≥ 1 ∶ 8 和< 1 ∶ 8,两者所生婴儿 6 个月以内 RPR 和 TPPA 阴转率差异有统计学意义(P < 0.05)。结论 妊娠梅毒在孕早期经过正规治疗后所生婴儿 RPR 和 TPPA 可在 18 个月全部转阴,不会导致先天梅毒的发生。
英文摘要:
      [Abstract] Objective To observe the serological changes of syphilis inneonateswith suspected congenital syphilis in early pregnancy after regularsyphilisexpelling therapy so as to provide epidemiological basis for the diagnosis treatment and prevention of congenital syphilis. Methods Pregnant patients who were diagnosed as syphilis in our hospital from 2012 to 2017 were selected and they were given regular treatment of benzathine penicillin in early pregnancy (within 20 weeks of gestation). The changes of serum anti-cardiolipin antibody (RPR) and treponema pallidum antibody (TPPA) after birth of neonates with suspected congenital syphilis were observed.The neonates with positive TPPA and/or RPR were reexamined once every 3 months (qualitative & quantitative) and TPPA (qualitative) until both of them turned negative, otherwise the longest time was 18 months after birth. The collected data were grouped and they were analyzed and processed by statistical methods. Results Two hundred and twenty-seven patients with suspected congenital syphilis who met the study inclusion criteriawere collected, including 123 males and 104 females.The average gestational age was (38.70±1.56) weeks. The average months of negative conversion of RPR and TPPA were (7.19±3.14) months. The negative conversion rates of suspected congenital syphilis infants were 48.02%, 88.99% and 100% respectively within1 month, within 6 months and within 12 months.The negative conversion rates of TPPA of suspected congenital syphilis infants wererespectively1.32%, 62.56%, 99.12% and 100%within1 month, within 6 months, within 12 months and within18 months. The RPR titer of the mother in one month before delivery was more than 1:8 and less than 1 ∶ 8. There were statistically significant differences in negative conversion rates of RPR and TPPA of infants within 6 months (P < 0.05). Conclusion After regular treatment during early pregnancy for patients with pregnantsyphilis, RPR and TPPA of their infantscan both turn negative in 18 months, which will not lead to congenital syphilis.
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