摘要
目的:分析梅毒孕妇所产新生儿血清学检测及转归情况。方法:选择2016年2月-2017年2月来本院治疗的单胎妊娠合并梅毒的孕妇160例及活产新生儿160例为研究对象。于新生儿出生前进行快速血清反应素试验(RPR)和梅毒螺旋体颗粒凝集(TPPA)试验,新生儿出生后3 d定期进行梅毒血清学检测。对妊娠合并梅毒的孕妇和新生儿梅毒血清学进行分析,比较不同时间段血清学转阴情况。结果:160例孕妇中,TPPA单阳性46例,RPR、TPPA双阳性114例,新生儿TPPA单阳性49例,111例为RPR和TPPA双阳性。孕妇单TPPA阳性与孕妇双阳性的新生儿梅毒血清测试结果比较,差异有统计学意义(P<0.05)。根据持续检测后,新生儿双阳性中,出生6个月后,RPR阳性已全部转阴;出生18个月后,TPPA阳性已全部转阴。新生儿单TPPA阳性中,出生18个月后,TPPA阳性已全部转阴。TPPA单阳性新生儿阴峰出现在出生后第5~6个月。孕妇RPR的滴度越高,新生儿RPR的阴性时间越长(P<0.05)。新生儿出生时RPR滴度在1︰1~1︰4时,新生儿的血清RPR阴性时间逐渐增加,但滴度为1︰8时的血清RPR阴性时间明显缩短;新生儿出生时RPR滴度阴性~1︰2,新生儿的血清TPPA阴性时间明显增加,RPR滴度1︰4~1︰8时,新生儿的血清TPPA阴性时间逐渐缩短。结论:经过治疗的妊娠合并梅毒孕妇所产新生儿梅毒血清学检查结果中RPR和TPPA双阳性占比仍然很高,孕妇产前RPR滴度高的新生儿阳性持续时间可能较长,但出生后一段时间内可转成阴性。建议对梅毒阳性新生儿进行长期随访,对先天性梅毒的诊断应慎重。
Objective:To analyze the serological detection and outcome of the neonates born to pregnant women with syphilis.Method:A total of 160 single pregnant women and 160 live births with syphilis who were treated in our hospital from February 2016 to February 2017 were selected as the research objects.The rapid serotonin test(RPR)and treponema pallidum particle agglutination test(TPPA)were performed before the newborn was born,the serological detection of syphilis was performed regularly 3 d after the newborn was born.The serology of pregnant women and neonates with syphilis during pregnancy were analyzed,the serology of syphilis in different periods was compared.Result:Among the 160 pregnant women,46 were single positive for TPPA,114 were double positive for RPR and TPPA,49 were single positive for neonatal TPPA,and 111 were double positive for RPR and TPPA.The results of neonatal syphilis serum detection were compared between pregnant women with single TPPA positive and pregnant women with double positive,the difference was statistically significant(P<0.05).According to the continuous detection,among the newborns who were double positive,RPR positive had all turned negative after 6 months of birth.18 months after birth,TPPA positive has all turned negative.Newborn single TPPA positive,18 months after birth,TPPA positive has all turned negative.The negative peak of TPPA single positive newborn appeared in the 5th to 6th month after birth.The higher the titer of maternal RPR was,the longer the negative time of neonatal RPR was(P<0.05).When the RPR titer was between 1︰1 and 1︰4 at birth,the serum RPR negative time of the newborn gradually increased,but the serum RPR negative time was significantly shortened when the titer was 1︰8.When the RPR titer of newborn was negative to 1︰2,the negative time of serum TPPA of newborn increased significantly.When the RPR titer was 1︰4 to 1︰8,the negative time of serum TPPA of newborn gradually decreased.Conclusion:The ratio of RPR and TPPA double positive in serological d
作者
孙健
SUN Jian(Jiamusi Maternal and Child Health Hospital,Jiamusi 154004,China)
出处
《中国医学创新》
CAS
2020年第17期144-147,共4页
Medical Innovation of China
关键词
梅毒
妊娠
新生儿
血清学检测
转归
Syphilis
Pregnancy
Newborn
Serological detection
Outcome
