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目的了解妇产科患者梅毒感染情况,为女性梅毒的防治尤其是孕产妇梅毒防治工作提供参考依据。方法选取2011-2015年天津市中心妇产科医院就诊的女性患者139 401例作为研究对象(不含新生儿),用酶联免疫吸附试验(ELISA)进行血清梅毒抗体筛查,阳性者用梅毒螺旋体抗体明胶凝集试验(TPPA)进行确证,两者均为阳性者认为梅毒血清学阳性,通过快速血浆反应素试验(RPR)检测其效价。对不同年度、不同年龄段和科室梅毒检测结果进行统计分析。结果共检出阳性患者1 197例,阳性率0.86%,阳性患者中TPPA阳性RPR效价阴性者占53.13%,RPR高滴度患者主要为21~30岁年龄组。妇瘤科检出率最高,产科最低。≤20岁年龄组检出率最高。近五年本院梅毒阳性检出率依次为0.80%,0.87%,0.82%,0.80%和1.00%,2011-2014年梅毒阳性检出率基本相近,2015年明显升高,与前4年相比差异有统计学意义(χ~2=8.745,P<0.01)。结论梅毒血清学阳性患者各科室均有检出,且有年轻化趋势,2015年产科梅毒检出率显著升高,加强年轻女性特别是孕妇梅毒筛查有利于降低梅毒垂直传播风险,进而控制梅毒传播。
Objective To understand the status of syphilis infection in obstetrics and gynecology patients and to provide reference for the prevention and control of female syphilis, especially for maternal syphilis. Methods A total of 139 401 female patients treated in Tianjin Obstetrics and Gynecology Hospital from 2011 to 2015 were selected as the study subjects (excluding newborns). Serum syphilis antibodies were screened by enzyme-linked immunosorbent assay (ELISA) The spirochete antibody gelatin agglutination test (TPPA) was validated, and positive for both were considered syphilis serologically positive and its titer was determined by the rapid plasma assay (RPR). Statistical analysis was made on the results of syphilis testing in different years, different age groups and departments. Results A total of 1 197 positive patients were detected, the positive rate was 0.86%. The positive rate of TPPA-positive RPR titer was 53.13% in positive patients. The patients with high RPR titer were 21-30 years old. Gynecology highest detection rate, obstetric minimum. ≤20 years old group the highest detection rate. In recent five years, the positive rate of syphilis in our hospital was 0.80%, 0.87%, 0.82%, 0.80% and 1.00% respectively. The positive rates of syphilis in 2011-2014 were similar, and were significantly higher in 2015. Compared with the first 4 years The difference was statistically significant (χ ~ 2 = 8.745, P <0.01). Conclusion The syphilis serological positive patients were detected in all the departments and there is a trend of younger tendency. The detection rate of obstetrician syphilis increased significantly in 2015. Strengthening screening of young women, especially pregnant women, is beneficial to reduce the risk of vertical transmission of syphilis and further control syphilis spread.