妊娠梅毒TRUST滴度及产前干预对先天梅毒发病的影响

目的探讨妊娠梅毒患者确诊时TRUST滴度与产前抗梅毒治疗对先天梅毒发病率的影响。方法将妊娠梅毒患者按其是否在妊娠期接受抗梅毒治疗分为治疗组（A组）和未治疗组（B组），按确诊时TRUST滴度分层比较2组间先天梅毒发病率的差异。结果A组先天梅毒发病率为1．95％，B组先天梅毒发病率为12．96％，两组间差异具有极显著统计学意义（x^2=18．4651，P=-0．000）。妊娠梅毒确诊时TRUST滴度≤1：2的孕产妇没有生育先天梅毒儿。A组妊娠梅毒确诊时TRUST滴度≥1：4的先天梅毒发病率3．70％（4／108），B组妊娠梅毒确诊时TRUST滴度≥1：4的先天梅毒发病率23．70％（321135），两组间差异有极显著统计学意义（x^2=19．017，P=0．000）。妊娠梅毒确诊时TRUST滴度≥1：4时，B组出现先天梅毒，且随着滴度的升高发病率大幅上升。结论母亲确诊时TRUST滴度的高低对梅毒垂直传播的发病率有重要的影响，可作为妊娠梅毒孕产妇选择妊娠结局的重要参考指标。

Impact of TRUST titre and antenatal intervention on incidence of syphilis

Objective To investigate the effect of TRUST titres at diagnosis and prenatal intervention of antenatal syphilis on congenital syphilis incidence. Methods According to whether or not accepted prenatal anti-virus treatments, antenatal syphilis mothers were allocated into a treatment group (group A) and a control group (group B). The incidences of congenital syphilis among the infants born to the syphilis mothers were compared by groups and by mothers' TRUST titres at diagnosis. Results The incidence of congenital syphilis in group A was 1.95%,while that in group B was 12.96%,showing statistically significant difference (x2=18.465,P=0.000) between the two groups. No congenital syphilis infant was born to mothers whose TRUST titres at diagnosis were ≤1:2. Among the infants of mothers with TRUST titres at diagnosis ≥1:4,the incidences of congenital syphilis was 3.70% (4/108) in group A and 23.70% (32/135) in group B (x2=19.017,P=0.000). The incidence of congenital syphilis rised greatly the increase of TRUST fitres of mothers in group B. Conclsuion 1. Most live-born infants were born to mothers with tertiary or late syphilis with low TRUST titres at diagnosis; 2. When mothers' TRUST titres at diagnosis were ≤1:2,the incidence of mother-to-child syphilis transmission became very low. Thus pregnancy termination is not suggested for mothers with low TRUST titres; 3. When mothers" TRUST titres at diagnosis were ≥1:4; 4. Mothers TRUST titres at diagnosis affected the rate of vertical syphilis transmission,the incidence of congenital syphilis increased with mothers' titres at diagnosis..