685例梅毒孕妇及其性伴配偶梅毒血清学分析

目的 了解梅毒阳性孕妇及其配偶/性伴梅毒感染状况,积极进行干预,避免胎传梅毒的发生。方法 收集2009-2016年通过海南省预防与控制梅毒母婴传播项目进行免费筛查后确诊为梅毒的685例梅毒孕妇及其配偶/性伴血清,进行梅毒血清学甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶颗粒凝集试验（TPPA）检测,根据孕妇TRUST滴度高低不同,分析与其配偶/性伴TRUST和TPPA阳性率的关系。结果 685例梅毒孕妇梅毒血清学TRUST和TPPA试验结果均为阳性,其TRUST滴度为1∶1~1∶256,其中≤1∶4有461例,1∶8~1∶32有165例,≥1∶64有59例。其配偶/性伴TRUST和TPPA试验阳性率分别为31.24%和37.37%,且随着孕妇梅毒TRUST滴度越高,配偶/性伴的TRUST和TPPA阳性率均呈上升趋势（P<0.01）,特别当孕妇TRUST滴度≥1∶16时,其配偶感染梅毒的机率≥50%;2009-2016年,发现妊娠梅毒的阳性数增高,但其配偶阳性率却逐年降低,其TRUST和TPPA的阳性率从60.00%和66.67%下降为23.45%和28.28%。结论 加强对梅毒阳性孕妇及其配偶/性伴的梅毒知识宣传和监测工作,及时追踪检测其配偶情况,可有效阻断了孕妇与其配偶/性伴间梅毒的传播,对防止胎传梅毒的发生有重要意义。

Syphilis serological analysis of 685 pregnant women with syphilis and their sexual partners

Objective To learn syphilis positive pregnant women and their spouses / partners TRUST and TPPA infection, and actively intervene to prevent the occurrence of fetal syphilis. Methods Collecting serum samples of 685 pregnant women with syphilis and their spouse / partners from 2009 to 2016 , who were diagnosed as syphilis, after free screening by Hainan Provincial Preventive and Controlling Syphilis Mother-to-Child Transmission Project, were collected for TRUST and TPPA test of syphilis serology. According to TRUST drip, to analyze the relationship between TRUST and TPPA positive rate of spouse / partner. Results The serological TRUST and TPPA tests of 685 syphilis pregnant women were both positive. The titer of TRUST was 1∶1 to 1∶256, of which 461 cases were less than 1∶4, 165 cases were 1∶8-1∶32, and 59 cases were more than 1∶64.The positive rate of TRUST test of the spouse / Sex partners was 31.24% and the positive rate of TPPA test was 37.37%. And the TRUST titer of syphilis in pregnant women was higher, TRUST, TPPA positive rate of the spouse / sex partners were higher（P<0.01）. Especially when the TRUST titer of pregnant women was more than 1∶16, the chance of infection of syphilis was more than 50%. From 2009 to 2016, the positive rate of syphilis increased, but the positive rate of their spouses decreased year by year, and the positive rate of TRUST and TPPA decreased from 60.00% and 66.67% to 23.45% and 28.28%. Conclusions The publicity and monitoring of syphilis knowledge on syphilis-positive pregnant women and their spouses / partners should be strengthened, which can effectively block the transmission of syphilis between the pregnant women and their spouses / partners and prevent the occurrence of fetal syphilis.