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CD3+、CD4+/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、C组(P<0.05),足月分娩率高于B组、C组(P<0.05),不良结局总发生率低于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、C组(均P<0.017)。结论对妊娠期梅毒病人来说,孕早期(孕周<13周)给予头孢曲松钠联合苄星青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。
Objective To investigate the effect of ceftriaxone sodium combined with benzathine penicillin on the immune function of pregnant women with syphilis in different gestational weeks and the maternal and infant outcomes.Methods A total of 152 syphilis patients during pregnancy admitted to the Department of Obstetrics and Gynecology in Hengshui Third Hospital from June 2016 to June 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 three groups 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 fullterm 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.
作者
陈风娥
闫博
史丽华
CHEN Fenge;YAN Bo;SHI Lihua(Department of Obstetrics and Gynecology,Hengshui Third Hospital,Hengshui,Hebei 053000,China)
出处
《安徽医药》
CAS
2023年第1期169-173,共5页
Anhui Medical and Pharmaceutical Journal
基金
衡水市科技计划项目(20190140132)。
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
Pregnancy complications,infectious
Ceftriaxone sodium
Benzathine penicillin
Gestational week
Syphilis dur‐ing pregnancy
Immune function
Maternal and infant outcome
