CAJ | 학술논문

目的探讨不同抗梅毒治疗方法对妊娠梅毒患者的妊娠结局及新生儿预后的影响.方法选择2010年1月至2012年1月成都市传染病医院收治的妊娠合并梅毒患者198例.根据孕期治疗情况,将患者分为规范治疗组(98例)、未规范治疗组(59例)和未治疗组(41例).采用Pearsonx2和卡方分割法比较各组的妊娠结局、新生儿预后及快速血浆反应环状卡片试验(RPR)转阴率等情况.结果流产、早产、死胎、死产、新生儿畸形等不良妊娠结局的发生率在规范治疗组、未规范治疗组及未治疗组分别为4.08％,27.12％和63.41％.先天梅毒儿、低体重儿、窒息儿、新生儿死亡等发生率在规范治疗组、未规范治疗组及未治疗组中逐渐升高,其中先天梅毒儿的发生率分别为2.06％,18.75％和35.29％.RPR高滴度(≥1∶8)的梅毒孕妇所产新生儿RPR滴度进行比较,规范治疗组较未规范治疗组和未治疗组明显下降,其差异具有统计学意义(x2=37.122,P＜0.01).新生儿RPR转阴率在规范治疗组、未规范治疗组及未治疗组中分别为100.00％,59.26％和25.00％,差异有统计学意义(x2=18.839,P＜0.01).结论规范的抗梅毒治疗是改善妊娠结局、新生儿预后及降低先天梅毒发生率的关键.
목적 탐토불동항매독치료방법대임신매독환자적임신결국급신생인예후적영향.방법 선택2010년1월지2012년1월성도시전염병의원수치적임신합병매독환자198례.근거잉기치료정황,장환자분위규범치료조(98례)、미규범치료조(59례)화미치료조(41례).채용Pearsonx2화잡방분할법비교각조적임신결국、신생인예후급쾌속혈장반응배상잡편시험(RPR)전음솔등정황.결과 유산、조산、사태、사산、신생인기형등불량임신결국적발생솔재규범치료조、미규범치료조급미치료조분별위4.08％,27.12％화63.41％.선천매독인、저체중인、질식인、신생인사망등발생솔재규범치료조、미규범치료조급미치료조중축점승고,기중선천매독인적발생솔분별위2.06％,18.75％화35.29％.RPR고적도(≥1∶8)적매독잉부소산신생인RPR적도진행비교,규범치료조교미규범치료조화미치료조명현하강,기차이구유통계학의의(x2=37.122,P＜0.01).신생인RPR전음솔재규범치료조、미규범치료조급미치료조중분별위100.00％,59.26％화25.00％,차이유통계학의의(x2=18.839,P＜0.01).결론 규범적항매독치료시개선임신결국、신생인예후급강저선천매독발생솔적관건.
Objective To investigate the effect of anti-syphilis treatment on the perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis.Methods One hundred and ninety eight pregnant women complicated with syphilis were collected from Chengdu Hospital of Infectious Diseases during January 2010 and January 2012,including 98 cases received standard treatment,59 cases received nonstandard treatment and 41 cases did not receive treatment.Pearson x2 and partition of chi-square were used for the comparison of pregnant outcomes,neonatal prognosis and negative rates of rapid plasma circle card test (RPR) among 3 groups.Results The incidence of adverse pregnancy outcomes,including miscarriage,prematurity,still birth and congenital malformation were 4.08％,27.12％ and 63.41％ in three groups,respectively.The incidence of congenital syphilis,low birth weight,asphyxia in infants and neonatal death raised in from standard-treatment group,nonstandard-treatment group to untreated group.Congenital syphilis rates were 2.04％,18.75％ and 35.29％ in three groups,respectively.RPR titers in newborns from mothers with high RPR titer (≥ 1 ∶ 8) in standard-treatment group were significantly lower than those in nonstandard-treatment group and untreated group (x2 =37.122,P ＜ 0.01).RPR negative rates were 100.00％,59.26％ and 25.00％ in three groups,respectively (x2 =18.839,P ＜ 0.01).Conclusion Standard anti-syphilis treatment can improve pregnant outcome,neonatal prognosis and reduce the incidence of congenital syphilis.