预防早产亚临床感染对妊娠结局影响的研究

To prevent premature subclinical infection the study of effect on pregnancy outcome

目的探讨早产亚临床感染与孕妇血清C-反应蛋白、白介素-6及下生殖道病原体的关系,并通过治疗达到防治早产的目的。方法选择我院2012年6月~2013年12月在产科诊断为先兆早产（28周〈孕周〈37周）或（和）未足月胎膜早破孕妇（28周〈孕周〈35周）作为研究对象,孕妇无严重并发症和合并症,A组孕妇入院后行阴道分泌物病原体检测（包括细菌性阴道病、滴虫、沙眼衣原体、支原体、霉菌）,行血分析白细胞计数,同时检查血清C-反应蛋白、白介素6,收治150例为研究组。B组入院后行血分析白细胞计数及中性粒细胞,并常规给予安胎治疗,收治150例为对照组。所有孕妇均无临床感染征象,两组产妇产后胎盘胎膜组织均行病理检查。结果研究组阴道炎有130例（其中BV感染有63例）,新生儿Apgar评分、产后胎盘病理诊断胎盘胎膜绒毛膜羊膜炎及延长孕周天数均高于对照组,差异有统计学意义（P〈0.05）;研究组新生儿窒息及肺炎均比对照组少。结论监测孕妇血清C-反应蛋白、白介素-6水平及下生殖道病原体有无感染,有助于早产亚临床感染的早期诊断,从而改善围产儿的结局。

Objective To study the relationship between premature pregnant women serum C-reactive protein,interleukin-6, lower genital tract pathogens and subclinical infection, And through the treatment to achieve the purpose of prevention and treatment of premature birth. Methods From June 2012 to December 2013 in obstetrical diagnosis of precursor（28 weeks 〈premature gestational age 〈 37 weeks） or（and） before term premature rupture of membranes（28weeks 〈pregnant gestational age 〈 35 weeks） as the research object, the pregnant woman without serious complications and complications, Group A pregnant woman was hospitalized after vaginal pathogen detection（including bacterial vaginal disease, trichomoniasis, chlamydia trachomatis and mycoplasma, mold）, check the white blood cell count, blood analysis and examination of serum C-reactive protein, interleukin-6, 150 patients treated for the team. Group B was hospitalized after blood leukocyte count and neutrophil, and Normal fetus treatment was given in 150 cases as control group. All pregnant women were no clinical signs of infection, two groups of maternal postpartum placenta tissue were pathologic examination. Results The team of research vaginitis with 130 cases（63 cases of BV infection）, neonatal Apgar score, placental pathologic and prolong gestational days were higher than the control group, the difference was statistically significant（P〈0.05）;Group compared with control group, the team of neonatal asphyxia and pneumonia were less than the control group. Conclusion Monitoring of pregnant women serum C-reactive protein, interleukin 6 levels and the presence of lower genital tract pathogens infection, will help premature in early diagnosis of subclinical infection, so as to improve the perinatal outcome.