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目的:探讨孕母梅毒快速血浆反应试验(rapid plasma regain,RPR)滴度与新生儿RPR阳性率及围生结局关系。方法:对2009年1月1日—2014年2月1日经RPR和梅毒螺旋体颗粒凝集试验筛查,192例妊娠合并梅毒孕母分娩前及其部分新生儿出生时及6月龄时外周血检测,比较孕母RPR滴度与新生儿RPR阳性率、阴转率及不良围生结局的关系。结果:新生儿RPR滴度与孕母呈正相关,孕母RPR滴度1∶1时,新生儿RPR阳性率68.4%;孕母RPR滴度1∶2时,新生儿RPR阳性率87.0%;当孕母RPR滴度≥1∶8时,新生儿RPR阳性率100.0%;孕母RPR滴度≥1∶8与≤1∶4比较,新生儿RPR阳性率差异有统计学意义(P<0.05)。孕母RPR滴度≥1∶8时,婴儿6月龄RPR阴转率下降,与RPR滴度≤1∶4比较,差异有统计学意义(P<0.05)。随着孕母RPR滴度的升高,畸形、死胎及新生儿死亡、早产及先天性梅毒的风险升高,婴儿不良结局风险升高。当孕母RPR滴度≥1∶8时,与孕母RPR滴度≤1∶4比较,新生儿畸形、早产、先天性梅毒增多,差异有统计学意义(P<0.05)。结论:随着孕母RPR滴度的升高,新生儿RPR阳性率升高,当RPR滴度≥1∶8时,新生儿RPR阳性率为100%,6月龄阴转率下降,胎儿畸形、早产、先天性梅毒发生率显著升高。
Objective: To investigate the relationship between rapid plasma response (RPR) titer and the RPR positive rate and perinatal outcome in neonates with gestational maternal syphilis. Methods: From January 1, 2009 to February 1, 2014, RPR and Treponema pallidum granulocyte agglutination test screening, 192 cases of pregnancy with syphilis pregnant mothers before delivery and part of newborns at birth and 6 months of age, peripheral blood To detect and compare the relationship between RPR titer of pregnant women and RPR positive rate, negative conversion rate and poor perinatal outcome in neonates. Results: The positive rate of RPR in neonates was positively correlated with that of pregnant mothers. The positive rate of RPR in neonates was 68.4% when the RPR titer was 1: 1, and the positive rate of RPR in neonates was 87.0% when RPR titer was 1: 2. The positive rate of RPR in neonates was 100.0% when the RPR titer of pregnant women was ≥1: 8, and the positive rate of RPR in newborns was statistically significant (P <0.05) . When RPR titer≥1: 8, the rate of RPR negative conversion in infants at 6 months decreased compared with RPR titer≤1: 4 (P <0.05). With the increase of pregnant mothers RPR titer, deformity, stillbirth and neonatal deaths, the risk of premature birth and congenital syphilis increased, the risk of adverse outcomes in infants increased. When pregnant mothers RPR titer ≥ 1: 8, compared with pregnant women RPR titer ≤ 1: 4, newborn malformations, premature birth, congenital syphilis increased, the difference was statistically significant (P <0.05). CONCLUSIONS: With the increase of RPR titer in pregnant women, the positive rate of RPR in neonates increases. When the RPR titer is 1: 8, the positive rate of RPR in newborn is 100%, the negative conversion rate in 6 months is declining, fetal malformation , Premature birth, congenital syphilis incidence was significantly higher.