学术论文

      泉州地区孕前健康体检梅毒及艾滋病检出的调查研究

      Investigation of syphilis and HIV detection in the health examination before pregnancy in Quanzhou

      摘要:
      目的:分析泉州地区孕前健康体检育龄女性中梅毒和艾滋的检出情况及趋势,为临床对育龄女性的生育健康宣教提供参考,降低梅毒和艾滋对新生儿的传播风险,提高人口素质.方法:收集泉州地区妇产专科医院和综合医院从2012年1月至2015年1月进行孕前健康体检的育龄者56834人的体检报告,整理梅毒和艾滋病的检出率,详细了解梅毒和艾滋阳性受检者的性别、年龄、职业及其它健康相关信息并与梅毒和艾滋阴性患者进行对比分析,了解影响孕前人群感染梅毒、艾滋的相关因素;对梅毒和艾滋阳性受检者进行跟踪分析,了解受检者后续治理方式、受孕情况及新生儿感染情况.结果:56834例实施孕前体检受检者中共检出梅毒阳性4428例,感染率为7.79%,艾滋阳性668例,艾滋感染率1.16%,214例为梅毒和艾滋同时阳性.将梅毒和(或)艾滋阳性患者作为观察组,共5310例,阴性作为对照组共51524例,两组在性别、年龄、居住地、文化背景、职业、官方性传播知识培训率方面比较存在显著性差异(P<0.05),说明这些因素和孕前感染梅毒和(或)艾滋有相关性.多因素分析进一步表明,未经官方性传播知识培训孕前育龄人群感染梅毒和(或)艾滋的的危险性最大(OR =3.912),其余依次为居住地为农村(OR=3.235)、小学以下学历(OR =2.968)、务农(OR=1.981).对3717例女性梅毒和(或)艾滋阳性患者进行跟踪随访,结果显示,3717例阳性受检者均采取了梅毒或艾滋治疗措施,其中2567例完成规范治疗后受孕,568例在治疗期间受孕,382例中途中断治疗受孕,200例未受孕.受孕的3517例女性中,3489例顺利产出新生儿,其中86例新生儿出现胎传梅毒,5例出现胎传艾滋.22例孕妇自行终止妊娠,6例孕妇流产.结论:临床应加强对育龄人群性传播疾病相关知识的宣传力度,提高孕前健康体检的覆盖率,进一步降低新生几梅毒、艾滋感染率.
      Abstract:
      Objectives:To analyze the incidence and trend of syphilis and AIDS among women of childbearing age in Quanzhou and to provide reference for the clinical education of female reproductive health,in order to reduce the transmission risk of HIV and syphilis in neonates and improve the population quality.Methods:The medical reports of 56834 women of childbearing age receiving pregnancy health examination in maternity hospital and comprehensive hospital in Quanzhou from January 2012 to January 2015 year were collected.The detection rates of syphilis and AIDS were analyzed.Gender,age,occupation and other health related information of syphilis and HIV positive subjects were analyzed to get factors related to syphilis and HIV infection.The syphilis and HIV positive subjects underwent follow-up tracking analysis,to understand the governance,pregnancy and neonatal infection.Results:Among the 56834 cases,there were 4428 cases of positive syphilis,and the infection rate was 7.79%.There were 668 cases of positive HIV infection,and HIV infection rate was 1.16%.There were 214 cases of both positive syphilis and HIV infection.The syphilis and (or) HIV positive patients were as the observation group (5310 cases).Negative infection patients were selected as the control group (51524 cases).The gender,age,residence,occupation,cultural background,official dissemination of knowledge training rate of two groups had significant difference (P < 0.05),indicating that these factors were correlated with pregnancy syphilis infection.Multivariate analysis further showed that the woman of childbearing age officially untreated with syphilis and sexually transmitted infection knowledge (or) was the greatest risk factors (OR =3.912),followed by the rest of the residence in rural area (OR =3.235),under primary school education (OR =2.968) and farming (OR =1.981).3717 cases of female syphilis and (or) the HIV positive patients were followed up.The results showed that 3717 cases were taken syphilis or HIV treatment,including 2567 cases who completed the treatment and was pregnant,568 cases who got pregnant during the treatment,and 382 cases who stopped the treatment and got pregnant and 200 cases without pregnancy.Among 3517 pregnant women,there were 3489 cases of successful pregnancy,including 86 cases of neonatal transmission of syphilis and 5 cases of fetal transmission of AIDS.22 pregnant women terminated pregnancy,and 6 pregnant women received abortion.Conclusion:The clinic should strengthen the knowledge propagandaof sexually transmitted diseases among reproductive population,and improve the pre-pregnancy health examination coverage,to further reduce neonatal syphilis and HIV infection rate.
      作者: 李燕 [1] 李祥双 [2]
      Author: LI Yan [1] LI Xiangshuang [2]
      作者单位: 泉州市丰泽区妇幼保健院妇产科,福建泉州362000;中国人民解放军第一八○医院健康管理中心妇科,福建泉州362000 中国人民解放军第一八○医院健康管理中心妇科,福建泉州,362000
      刊 名: 中国性科学 ISTIC
      年,卷(期): 2017, 26(11)
      分类号: R759.1
      在线出版日期: 2017年12月22日