妊娠合并梅毒孕期规范治疗后对新生儿梅毒血清学的影响

摘要

目的：对妊娠合并梅毒孕期规范治疗后新生儿梅毒血清学的变化特点及转归进行分析。方法：选取2011年1月至2013年1月间经孕期规范治疗的妊娠合并梅毒孕产妇150例，于孕妇产前1周进行 RPR 及 TPPA 试验，并对新生儿娩出3d 后及以后定期进行梅毒血清学检查，对不同时间血清学转阴情况进行分析。结果：（1）150例新生儿中106例 RPR、TPPA 双阳性，44例单 TPPA 阳性。与 TPPA 单阳性母亲新生儿相比，RPR、TPPA 双阳性母亲的新生儿 RPR 阳性比例较高（P ＜0．05）。（2）随访中 RPR、TPPA 双阳性新生儿转阴高峰在出生后2个月，而 TPPA 单阳性新生儿转阴高峰为出生后6～12个月间。（3）孕妇产前RPR 滴度越高，新生儿血清 RPR 转阴时间越长（P ＜0．05），而孕妇产前 RPR 滴度与新生儿 TPPA 转阴时间无关（P ＜0．05）。新生儿出生时 RPR 滴度越高则新生儿转阴时间越长，滴度于1∶1～1∶4间的新生儿，TPPA转阴时间更长（P ＜0．05）。结论：妊娠合并梅毒孕期规范治疗后所分娩新生儿的梅毒血清检查结果多呈阳性，且母亲 RPR 滴度越高的新生儿，其梅毒血清检测呈阳性的时间越长，但 RPR 均能转阴。%Objectives:To study the characteristics and prognosis of neonatal syphilis serology with syphilis during pregnancy after standard treatment.Methods:150 pregnant women with syphilis were chosen from 2011 Jan~2013 Jan,who received standard treatment.RPR and TPPA test were conducted one week before delivery.The syphilis serology examination was performed 3 days after delivery and regularly thereafter.The seroconversion at dif-ferent times was also analyzed.Results:(1)There were 106 cases of double positive of RPR and TPPA,44 cases of single positive TPPA in the 150 newborns.Compared to the TPPA single positive mothers of newborn,the RPR positive ratio of neonatal whose mothers are double positive of TPPA and RPR was higher (P <0.05).(2)The se-roconversion of newborns with double positive of RPR and TPPA occurred 2 months after birth,while that of newbo-rns with single positive of TPPA happened 6 ~12 months after birth.(3)The higher the prenatal RPR titer was,the longer it took for the seroconversion of neonatal serum RPR (P <0.05),while there was no connection between prenatal RPR titer with neonatal TPPA clearance time (P <0.05).The higher the neonatal RPR titer was,the lon-ger it took for neonatal clearance,and peaked reached when the titer was between 1:1 ~1:4 (P <0.05 ). Conclusion:The syphilis serum examination of newborns is always positive after receiving standard treatment during pregnancy.Moreover,the newborns whose mothers have higher RPR titer are to have longer positive time but they will all return to negative finally.