血清IL-6、PCT、TNF-α与GBS感染孕妇不良妊娠结局的关系

Relationship between serum IL-6,PCT,TNF-αand adverse pregnancy outcomes in pregnant women with GBS infection

目的分析血清白介素-6(IL-6)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)与B族链球菌(GBS)感染孕妇不良妊娠结局的关系。方法选取2020年5月至2022年3月于首都医科大学附属北京天坛医院进行产检以及生产的125例GBS感染孕妇为研究对象(GBS组),另选取同期收治的健康产妇100名为对照组。对比GBS组、对照组血清IL-6、PCT、TNF-α水平;比较两组妊娠结局;分析影响GBS感染孕妇不良妊娠结局的单因素;采用多元Logistic回归分析影响GBS感染孕妇不良妊娠结局的危险因素。结果对照组IL-6、PCT、TNF-α水平均低于GBS组,差异有统计学意义(P<0.05);对照组早产、胎膜早破、胎儿窘迫、新生儿GBS感染以及新生儿病理性黄疸的发生率均低于GBS组,差异有统计学意义(P<0.05);经检查、追踪发现,GBS组有37例产妇有不良妊娠结局,88例产妇为正常妊娠结局;不良妊娠结局组与正常妊娠结局组孕周、是否为初产妇等指标比较,差异无统计学意义(P>0.05);两组年龄、GBS感染分级、血清IL-6、PCT、TNF-α水平比较,差异有统计学意义(P<0.05);经多元Logistic回归分析显示:年龄≥35岁、GBS感染分级为GBS带菌或GBS性绒毛膜羊膜炎、IL-6>0.463 ng/L、PCT≥0.5 ng/mL、TNF-α≥30 fmol/mL均是影响GBS感染孕妇不良妊娠结局的危险因素(P<0.05)。结论血清IL-6、PCT、TNF-α水平在GBS感染产妇不良妊娠结局患者中呈升高状态,三指标可作为监测、预防GBS感染产妇不良妊娠结局的重要指标。

Objective To analyze the relationship between serum interleukin-6(IL-6),procalcitonin(PCT),tumor necrosis factor-α(TNF-α)and adverse pregnancy outcomes in pregnant women infected with Group B streptococcus(GBS).Methods 125 GBS infection-positive women who underwent Beijing Tiantan Hospital,Capital Medical University and gave birth in this court from May 2020 to March 2022 were selected as the research subjects(GBS group),another 100 healthy pregnant women admitted during the same period were selected as the control group.The serum IL-6,PCT,and TNF-αlevels between the GBS group and the control group were compared.The pregnancy outcomes between the two groups were compared.The single factors that affected adverse pregnancy outcomes in pregnant women with GBS infection were analyzed.The multiple logistic regression was used to analyze the risk of adverse pregnancy outcomes in pregnant women with GBS infection factor.Results The levels of IL-6,PCT,and TNF-αin the control group were lower than those in the GBS group(P<0.05).The incidence rates of premature birth,premature rupture of membranes,fetal distress,neonatal GBS infection and neonatal pathological jaundice in the control group were low-er than those in the GBS group(P<0.05).After inspection and follow-up,it was found that 37 women in the GBS group had adverse pregnancy outcomes and 88 women had normal pregnancy outcomes;there was no statistically significant difference in the adverse pregnancy outcome group and the normal pregnancy outcome group in terms of gestational age,whether they were primipara,etc.(P>0.05).Comparing the age,GBS infection grade,serum IL-6,PCT,and TNF-αlevels between the two groups showed statistically significant differences(P<0.05).Multiple logistic regression analysis showed that:age≥35 years old,the classification of GBS infection as GBS carrier or GBS chorioamnionitis,IL-6>0.463 ng/L,PCT≥0.5 ng/mL,and TNF-α≥30 fmol/mL were risk factors for adverse pregnancy outcomes in pregnant women with GBS infection(P<0.05).Conclusion Serum IL-6,PCT,and TNF-αlevels are elevated in patients with adverse pregnancy outcomes in GBS-infected mothers.The three indicators can be used as important indicators for monitoring and preventing adverse pregnancy outcomes in GBS-infected mothers.