中华皮肤科杂志 ›› 2026, Vol. 59 ›› Issue (10): 979-987.doi: 10.35541/cjd.20260254

• 论著·性传播疾病 • 上一篇    下一篇

妊娠期梅毒管理指南的质量评价与差异比较

张钰燕1    刘康萍1    王前2    王潇滟2    高群2    宋波2    王雨2    李希涵3    王爱玲2   

  1. 1中国疾病预防控制中心，北京  102206；2国家卫生健康委妇幼健康中心，北京  100081；3首都医科大学公共卫生学院，北京  100069
  • 收稿日期:2026-05-08 修回日期:2026-07-29 发布日期:2026-10-07
  • 通讯作者: 王爱玲 E-mail:ailing@chinawch.org.cn

Quality appraisal and comparative analysis of guidelines for the management of syphilis in pregnancy

Zhang Yuyan¹, Liu Kangping¹, Wang Qian², Wang Xiaoyan², Gao Qun², Song Bo², Wang Yu², Li Xihan³, Wang Ailing²   

  1. ¹Chinese Center for Disease Control and Prevention, Beijing 102206, China; ²National Center for Women and Children′s Health, National Health Commission, Beijing 100081, China; ³School of Public Health, Capital Medical University, Beijing 100069, China
  • Received:2026-05-08 Revised:2026-07-29 Published:2026-10-07
  • Contact: Wang Ailing E-mail:ailing@chinawch.org.cn

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摘要： 【摘要】 目的 系统评价国内外妊娠期梅毒管理相关指南的方法学质量与报告规范性，比较其推荐意见的异同，为我国制订妊娠期梅毒管理指南提供参考。方法 系统检索中英文数据库及机构网站自建立至2025年7月的数据，纳入妊娠期梅毒管理相关指南，采用临床指南研究与评估系统Ⅱ（AGREE Ⅱ）评估其方法学质量，采用国际实践指南报告规范（RIGHT）评价其报告规范性，计算标准化得分并进行综合质量分类，比较核心推荐意见。结果 共纳入10篇指南。AGREE Ⅱ评价显示，“清晰性”领域得分最高（87.78% ± 11.58%），“严谨性”领域得分最低（56.25% ± 23.86%）。RIGHT评价显示，“背景”领域得分最高（75.63% ± 18.15%），“评审和质量保证”领域得分最低（43.75% ± 30.19%）。综合质量评价显示，4篇为高质量，5篇为中等质量，1篇为低质量。推荐意见比较显示，9篇指南均强烈建议首次产检时或尽早对孕妇进行梅毒筛查，涉及治疗方案的指南均将苄星青霉素作为一线治疗方案，但在筛查频率及非青霉素替代药物选择上存在差异。结论 现有妊娠期梅毒管理指南在质量和内容上存在相似性与异质性，多数指南方法学严谨性和报告完整性有待提升，推荐意见差异反映本领域高质量证据普遍匮乏。

关键词: 梅毒, 妊娠并发症, 感染性, 指南, 母婴传播, AGREE Ⅱ, RIGHT清单

Abstract: 【Abstract】 Objective To systematically evaluate the methodological quality and reporting quality of guidelines for the management of syphilis in pregnancy in China and other countries, to assess similarities and differences in their recommendations, and to provide references for developing high-quality, context-appropriate guidelines in China. Methods Guidelines were retrieved from Chinese and English databases and official websites of relevant organizations from inception to July 2025. The Appraisal of Guidelines for Research and Evaluation Ⅱ （AGREE Ⅱ） instrument was used to assess the methodological quality of the included guidelines, and the Reporting Items for Practice Guidelines in Healthcare （RIGHT） checklist to evaluate their reporting compliance. Domain standardized scores were calculated, and guidelines were classified according to their comprehensive quality. Core recommendations were synthesized and compared. Results A total of 10 guidelines were included. The AGREE Ⅱ instrument-based assessment showed that the “clarity of presentation” domain had the highest score （87.78% ± 11.58%）, while the “rigour of development” domain had the lowest score （56.25% ± 23.86%）. The RIGHT checklist-based assessment showed that the “background” domain had the highest score （75.63% ± 18.15%）, whereas the “review and quality assurance” domain had the lowest score （43.75% ± 30.19%）. Comprehensive quality assessment revealed that 4 guidelines were classified as high quality, 5 as moderate quality, and 1 as low quality. Comparison of recommendations showed that 9 guidelines strongly recommended syphilis screening for pregnant women at the first antenatal visit or as early as possible, and all the guidelines mentioning treatment recommended benzathine penicillin as a first-line treatment. However, recommendations on screening frequency and non-penicillin alternatives varied across guidelines. Conclusions Current guidelines for the management of syphilis in pregnancy exhibit similarities and differences in both quality and content. Most guidelines require improvements in methodological rigor and reporting completeness. Differences in recommendations reflect a general lack of high-quality evidence in this field.

Key words: Syphilis, Pregnancy complications, infectious, Guidelines, Mother-to-child transmission, AGREE Ⅱ, RIGHT checklist

引用本文

张钰燕 刘康萍 王前 王潇滟 高群 宋波 王雨 李希涵 王爱玲. 妊娠期梅毒管理指南的质量评价与差异比较[J]. 中华皮肤科杂志, 2026,59(10):979-987. doi:10.35541/cjd.20260254

Zhang Yuyan¹, Liu Kangping¹, Wang Qian², Wang Xiaoyan², Gao Qun², Song Bo², Wang Yu², Li Xihan³, Wang Ailing². Quality appraisal and comparative analysis of guidelines for the management of syphilis in pregnancy[J]. Chinese Journal of Dermatology, 2026, 59(10): 979-987.doi:10.35541/cjd.20260254