| 陈风娥,闫博,史丽华.头孢曲松钠联合苄星青霉素对不同孕周的妊娠期梅毒孕妇免疫功能及母婴结局的影响[J].安徽医药,2023,27(1):169-173. |
| 头孢曲松钠联合苄星青霉素对不同孕周的妊娠期梅毒孕妇免疫功能及母婴结局的影响 |
| Effects of ceftriaxone sodium combined with benzathine penicillin on the immune function of pregnant women with syphilis in different gestational weeks and maternal and infant outcomes |
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| DOI：10.3969/j.issn.1009-6469.2023.01.037 |
| 中文关键词: 妊娠并发症，感染性 头孢曲松钠 苄星青霉素 孕周 妊娠期梅毒 免疫功能 母婴结局 |
| 英文关键词: Pregnancy complications,infectious Ceftriaxone sodium Benzathine penicillin Gestational week Syphilis during pregnancy Immune function Maternal and infant outcome |
| 基金项目:衡水市科技计划项目( 20190140132) |
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| 中文摘要: |
| 目的探讨头孢曲松钠联合苄星青霉素对不同孕周的妊娠期梅毒孕妇免疫功能及母婴结局的影响。方法选取 2016年 6月至 2019年 6月衡水市第三人民医院妇产科收治的妊娠期梅毒病人 152例，均给予头孢曲松钠联合苄星青霉素治疗，按首次治疗时所在孕周分为 A组( n=52，孕周 <13周)、 B组( n=61，孕周 13~27周)、 C组( n=39，孕周 >27周)，比较三组免疫功能、母婴结局、氧化应激、母婴甲苯胺红不加热血清试验( TRUST)阴性率、滴度情况。结果治疗后三组 CD3+(62.85±3.89、57.72±4.03、57.13±4.11)、 CD4+/CD8+(1.97±0.44、1.58±0.41、1.46±0.38)均高于治疗前( 51.07±4.54、51.35±4.06、50.73±4.45、1.19±0.38、1.14±0.36、1.12±0.34)(P<0.05)CD8+(22.32±6.68、26.68±6.05、28.23±5.74)均低于治疗前( 33.01±5.15、32.76±5.34、33.12±4.95)(P<0.05)且治疗后 A组 CD3D4+/CD8+均高于 B组、 C组( P<0.05)CD8+均低于 B组、 C组( P<0.05)。 A组孕妇分娩孕周均晚于 B组组( P<0.05)，足月分娩率高于 B组、 C组( P<0.05)，不良结发生率低于 B组、 C组( P<0.05)，新生儿 1 min阿氏( Apgar)评分均大于 B组、 C组( P<0.05)，5 min Apgar评分均大于 B组、 C组( P<0.05)，新生儿窒息发生率与 NCS发生率均低于 B组、 C组( P<0.05)。治疗后三组晚期氧化蛋白产物( AOPP)、丙二醛均低于治疗前( P<0.05)，超氧化物歧化酶( SOD)均高于治疗前( P<0.05)且治疗后 A组 AOPP、丙二醛均低于 B组、 C组( P<0.05)SOD均高于 B组、 C组(P<0.05)。 A组新生儿 TRUST阴性率高于 B组(均 P<0.017)。结论对妊娠期梅毒病人来说，期(孕周 <13周)给予头孢曲松钠联合苄星青+、C，、C，局总，组、C，孕早，霉素治疗更利于增强病人免疫功能，改善母婴结局，减轻病人氧化应激水平，提高新生儿 TRUST阴性率。 |
| 英文摘要: |
| Objective To investigate the effect of ceftriaxone sodium combined with benzathine penicillin on the immune functionof pregnant women with syphilis in different gestational weeks and the maternal and infant outcomes.Methods A total of 152 syphilispatients during pregnancy admitted to the Department of Obstetrics and Gynecology in Hengshui Third Hospital from June 2016 toJune 2019 were treated with ceftriaxone sodium combined with benzathine penicillin. They were assigned into group A (n=52, gestational age < 13 weeks), group B (n=61, gestational age ranged from 13 to 27 weeks), and group C (n=39, gestational age >27 weeks) according to the gestational age at the time of the first treatment. The immune function, maternal and infant outcomes, oxidative stress, negative rate of maternal and infant toluidine red unheated serum test (TRUST) and titer were compared among the three groups.Results After treatment, the CD3+ [(62.85±3.89), (57.72±4.03), (57.13±4.11)], CD4+/CD8+ [(1.97±0.44), (1.58±0.41), (1.46±0.38)] in the threegroups were higher than before treatment [(51.07±4.54), (51.35±4.06), (50.73±4.45), (1.19±0.38), (1.14±0.36), (1.12±0.34)] (P<0.05),and CD8+ [(22.32±6.68), (26.68±6.05), (28.23±5.74)] was lower than before treatment [(33.01±5.15), (32.76±5.34), (33.12±4.95)] (P< 0.05). After treatment, the CD3+, CD4+/CD8+ in group A were higher than those in groups B and C (P<0.05), and CD8+ was lower than in groups B and C (P<0.05). The gestational weeks of the pregnant women in group A were longer than those in groups B and C (P< 0.05), the rate of full-term delivery was higher than that in groups B and C (P<0.05), and the total incidence of adverse outcomes was lower than that in groups B and C ( P<0.05). The 1 min Apgar score of neonates was higher in group A than groups B and C (P<0.05), and 5 min Apgar score was also higher in group A than groups B and C (P<0.05). The incidences of neonatal asphyxia and NCS were lower than those of groups B and C (P<0.05). After treatment, advanced oxidation protein products (AOPP) and malondialdehyde(MDA) of the three groups were lower than before treatment (P<0.05), and superoxide dismutase (SOD) was higher than before treatment (P<0.05). AOPP and MDA of group A were lower than those of groups B and C (P<0.05), and SOD of group A was higher than that of groups B and C (P<0.05) after treatment. The neonatal TRUST negative rate in group A was higher than that in groups B and C (all P< 0.017).Conclusion For patients with syphilis during pregnancy, treatment with ceftriaxone sodium combined with benzathine penicillin in the first trimester (gestational age <13 weeks) is more beneficial to enhance the immune function of the patients, improve the maternal and infant outcomes, reduce the oxidative stress level of the patients, and improve the TRUST negative rate of the newborn babies. |
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