目的:探讨不同驱梅治疗时机对妊娠期梅毒患者妊娠结局,母婴快速血浆反应素试验(RPR)结果,新生儿Apgar评分以及胎传梅毒的影响。方法:选择甘肃省第二人民医院与玛曲县人民医院2019年1月至2021年12月收治的100例妊娠期梅毒患者作为研究对...目的:探讨不同驱梅治疗时机对妊娠期梅毒患者妊娠结局,母婴快速血浆反应素试验(RPR)结果,新生儿Apgar评分以及胎传梅毒的影响。方法:选择甘肃省第二人民医院与玛曲县人民医院2019年1月至2021年12月收治的100例妊娠期梅毒患者作为研究对象,按照接受驱梅治疗时机的不同分成3组,其中早期组(孕<12周)38例,中期组(孕12~27周)32例,晚期组(孕≥28周)30例。比较3组不良妊娠结局情况、母婴RPR滴度、新生儿出生后1 min和5 min的Apgar评分及新生儿胎传梅毒发病率。结果:早期组、中期组和晚期组的不良妊娠结局发生率分别为7.89%(3/38)、34.38%(11/32)和53.33%(16/30),其中早期组不良妊娠结局发生率显著低于中期组和晚期组(P<0.05)。早期组和中期组妊娠期患者RPR滴度<1∶8的比率均显著高于晚期组(P<0.05);早期组新生儿RPR滴度<1∶8的比率显著高于中期组和晚期组(P<0.05)。早期组新生儿出生后1 min和5 min Apgar评分均显著高于中期组和晚期组(P<0.05);中期组新生儿出生后1 min和5 min Apgar评分均显著高于晚期组(P<0.05)。早期组、中期组及晚期组胎传梅毒发生率分别为0(0/38)、6.25%(2/32)及26.67%(8/30),早期组和中期组胎传梅毒发生率均显著低于晚期组,差异有统计学意义(P<0.05)。结论:妊娠期梅毒患者在孕早期进行驱梅治疗可有效减少不良妊娠结局、降低母婴RPR滴度,并能有效阻断梅毒垂直传播,降低胎传梅毒的发生风险。展开更多
BACKGROUND The prevalence of gestational diabetes mellitus(GDM)has been increasing worldwide and is associated with multiple adverse pregnancy outcomes.Despite standard screening,some cases remain undiagnosed.Fibrobla...BACKGROUND The prevalence of gestational diabetes mellitus(GDM)has been increasing worldwide and is associated with multiple adverse pregnancy outcomes.Despite standard screening,some cases remain undiagnosed.Fibroblast growth factor 21(FGF21)plays a role in modulating glucose metabolism.There is an ongoing controversy regarding the relevance of FGF21 to GDM.AIM To evaluate the association between early second trimester serum FGF21 levels and gestational diabetes,and its predictive potential for outcomes.METHODS This cross-sectional observational study was conducted at a tertiary medical center,Chiang Mai University,Thailand.It included 28 pregnant women diag-nosed with GDM and 81 pregnant women with normal glucose status.Blood samples were collected according to the study schedule,and pregnancy outcomes were recorded meticulously.Descriptive analysis was employed to evaluate the data.RESULTS Most participants in our study had no risk factors for GDM(body mass index<24 kg/m2,no first-degree relatives with diabetes,no history of GDM),normal baseline glucose status(fasting glucose<110 mg/dL),and no insulin resistance(homeostatic model assessment of insulin resistance<2).There was a trend of increased FGF21 levels in the insulin-treated GDM group compared with dietary-treated GDM and non-GDM(73.58 pg/mL vs 62.94 pg/mL vs 63.59 pg/mL,respectively,P=0.73).However,no significant association was found between FGF21 concen-trations and pregnancy outcomes based on quintiles of FGF21 levels.CONCLUSION FGF21 was not associated with GDM or pregnancy outcomes;however,due to the small sample size,larger clinical trials with a diverse population are suggested to confirm these results.展开更多
文摘目的:探讨不同驱梅治疗时机对妊娠期梅毒患者妊娠结局,母婴快速血浆反应素试验(RPR)结果,新生儿Apgar评分以及胎传梅毒的影响。方法:选择甘肃省第二人民医院与玛曲县人民医院2019年1月至2021年12月收治的100例妊娠期梅毒患者作为研究对象,按照接受驱梅治疗时机的不同分成3组,其中早期组(孕<12周)38例,中期组(孕12~27周)32例,晚期组(孕≥28周)30例。比较3组不良妊娠结局情况、母婴RPR滴度、新生儿出生后1 min和5 min的Apgar评分及新生儿胎传梅毒发病率。结果:早期组、中期组和晚期组的不良妊娠结局发生率分别为7.89%(3/38)、34.38%(11/32)和53.33%(16/30),其中早期组不良妊娠结局发生率显著低于中期组和晚期组(P<0.05)。早期组和中期组妊娠期患者RPR滴度<1∶8的比率均显著高于晚期组(P<0.05);早期组新生儿RPR滴度<1∶8的比率显著高于中期组和晚期组(P<0.05)。早期组新生儿出生后1 min和5 min Apgar评分均显著高于中期组和晚期组(P<0.05);中期组新生儿出生后1 min和5 min Apgar评分均显著高于晚期组(P<0.05)。早期组、中期组及晚期组胎传梅毒发生率分别为0(0/38)、6.25%(2/32)及26.67%(8/30),早期组和中期组胎传梅毒发生率均显著低于晚期组,差异有统计学意义(P<0.05)。结论:妊娠期梅毒患者在孕早期进行驱梅治疗可有效减少不良妊娠结局、降低母婴RPR滴度,并能有效阻断梅毒垂直传播,降低胎传梅毒的发生风险。
基金Supported by The Faculty of Medicine Research Fund,Chiang Mai University,Thailand,No.017/2564.
文摘BACKGROUND The prevalence of gestational diabetes mellitus(GDM)has been increasing worldwide and is associated with multiple adverse pregnancy outcomes.Despite standard screening,some cases remain undiagnosed.Fibroblast growth factor 21(FGF21)plays a role in modulating glucose metabolism.There is an ongoing controversy regarding the relevance of FGF21 to GDM.AIM To evaluate the association between early second trimester serum FGF21 levels and gestational diabetes,and its predictive potential for outcomes.METHODS This cross-sectional observational study was conducted at a tertiary medical center,Chiang Mai University,Thailand.It included 28 pregnant women diag-nosed with GDM and 81 pregnant women with normal glucose status.Blood samples were collected according to the study schedule,and pregnancy outcomes were recorded meticulously.Descriptive analysis was employed to evaluate the data.RESULTS Most participants in our study had no risk factors for GDM(body mass index<24 kg/m2,no first-degree relatives with diabetes,no history of GDM),normal baseline glucose status(fasting glucose<110 mg/dL),and no insulin resistance(homeostatic model assessment of insulin resistance<2).There was a trend of increased FGF21 levels in the insulin-treated GDM group compared with dietary-treated GDM and non-GDM(73.58 pg/mL vs 62.94 pg/mL vs 63.59 pg/mL,respectively,P=0.73).However,no significant association was found between FGF21 concen-trations and pregnancy outcomes based on quintiles of FGF21 levels.CONCLUSION FGF21 was not associated with GDM or pregnancy outcomes;however,due to the small sample size,larger clinical trials with a diverse population are suggested to confirm these results.
