梅毒血清固定患者的妊娠结局及随访研究

目的探讨中药对梅毒血清固定患者的妊娠结局的影响及婴儿的血清学特点。方法孕前采用中药治疗的（32例）育龄期梅毒血清固定女患者为中药治疗组；对照组选择同期56例妊娠合并梅毒血清固定患者，根据孕期是否规范治疗分为青霉素治疗组（31例）和未治疗组（25例）。比较三组孕妇的妊娠结局，并定期随访母婴的血清结果。结果妊娠结局：中药治疗组足月分娩率为90．63％，早产发生率为3．13％，不良结局（自然流产和死胎死产）发生率为6．25％青霉素治疗组分别为90．32％、6．45％和3．22％；未治疗组分别为88％、4％和8％；三组妊娠结局比较，差异无统计学意义（P〉0．05）；新生儿预后：中药治疗组分娩正常新生儿占96．67％、早产儿占3．33％、先天梅毒为0；青霉素治疗组分别为93．33％、6．67％和0；未治疗组分别95．65％、4．34％和0。三组新生儿预后比较，差异无统计学意义（P〉0．05）；婴儿血清结果：在随访过程中没有出现TRUST滴度持续上升，且滴度均〈母亲TRUST滴度的4倍；TRUST在3-6个月内均逐渐阴转，TPPA在6-12个月内均逐渐阴转；所有婴儿的19S-IgM-TPPA（-）。结论梅毒血清固定患者在孕前给予中药治疗对妊娠结局无影响，定期随访是评估母婴预后的重要环节。

Pregnancy outcome and follow-up of sero-fixation syphilis patients.

Objective To investigate the effect of traditional Chinese medicine（TCM） on pregnancy outcomes of serofixa- tion syphilis patients and the serologic characteristics of infants. Methods The 32 female serofixation syphilis patients of child-bearing age in the TCM treatment group were treated with TCM prior to conception; 56 pregnant sero-fixation syphilis pa- tients at the same period were chosen as the control groups, and then they were divided into penicillin treatment group （31 cas- es） and untreated group （25 cases）,according to if they were treated or not during pregnancy. The maternal and infant serologic results were pregnancy followed up and the outcomes of the three groups were compared. Results Pregnant outcomes ： In the TCM treatment group pregnant outcomes of the term delivery rate,preterm birth rate and adverse outcomes （spontaneous abor- tions and stillbirths） were 90.63%,3.13% and 6.25%; while that in the penicillin treatment group were 90.32%, 6.45% and 3.22%;The rates in untreated group were 88%, 4% and 8% respectively. Pregnant outcomes among the three groups did not show statistically significant difference （P〉 0.05）. Neonatal prognosis： In the TCM treatment group, the normal neonatal birth, premature and congenital syphilis accounted for 96.67%, 3.33% and 0; that in penicillin treatment group were 93.33%, 6.67% and 0 ,while that in the untreated group were 95.65%, 4.34% and 0,respectively, without showing significant differences among the three groups （P〉 0.05）. The TRUST titers didn＇ t arise continuously during followup, and infant serum TRUST titers were 4 times lower than their mothers; their serum TRUST wwas converted negative gradually 3 to 6 months later and TPPA was con- verted negative 6 to 12 months later; all the infants serologic 19S-IgM-TPPA were negative. Conclusions Treatment with TCM before pregnancy would not affect the outcome of pregnancy of sero-fixation syphilis patients and regular follow-up is in- dicated.