动态监测产褥感染产妇血清细胞因子及抗氧化能力指标的临床价值

Clinical value of dynamic monitoring of serum cytokines and the oxidation resistance indexes in puerpera with puerperal infection

目的动态监测产褥感染产妇血清细胞因子及抗氧化能力指标的变化,并探讨其临床价值。方法选择2013年7月至2014年12月在湖北孝昌县第一人民医院妇产科住院治疗的67例产褥感染患者为观察组,其中外阴阴道及宫颈炎22例,子宫内膜炎及输卵管炎26例,盆腔腹膜炎19例。选择同期住院分娩未发生产褥感染的65例产妇作为对照组。分别在产后1、3、5 d检测各组产妇血清白细胞介素-6(interleukin-6,IL-6)、血清C-反应蛋白(C-reaction protein,CRP)、抗凝血酶原Ⅲ(antithrombinⅢ,AT-Ⅲ)、降钙素原(procalcitionin,PCT)等细胞因子水平及总抗氧化能力(total antioxidant capacity,TAC)、超氧化歧化酶(superoxide dismutase,SOD)、脂质过氧化产物丙二醛(malonaldehyde,MDA)、髓过氧化化物酶(myeloperoxidase,MPO)等抗氧化能力指标。结果观察组不同时间点血清IL-6、CRP、PCT、MDA、MPO水平均明显高于对照组(P<0.05);AT-Ⅲ、TAC、SOD明显低于对照组(P<0.05)。随着产褥感染产妇的病情加重,血清IL-6、CRP、PCT、MDA、MPO水平逐渐升高(P<0.05),而血清AT-Ⅲ、TAC、SOD逐渐降低(P<0.05)。结论动态监测血清细胞因子和抗氧化能力指标有助于判断产褥感染病情的严重程度,具有一定的临床价值。

Objective To dynamic monitor the change of serum cytokines and the oxidation resistance indexes of puerpera with puerperal infection,and to explore its clinical value. Methods 67 patients with puerperal infection hospitalized in The First People＇s Hospital of Xiaochang County from July 2013 to December 2014 were selected as observation group, in which 22 cases with vulvovaginal and cervicitis,26 cases with endometritis and salpingitis and 19 cases with pelvic peritonitis. At the same time,65 cases of puerpera with no- puerperal infection were selected as control group. The levels of serum interleukin 6（ IL- 6）,serum C- reactive protein（ CRP）,antithrombin Ⅲ（ AT- Ⅲ）,calcitonin original cytokines（ PCT） and total antioxidant capacity（ TAC）,super oxide dismutase（ SOD）,lipid peroxidation product malondialdehyde（ MDA）,pulp compound peroxide enzyme（ MPO） in all groups were respectively detected in postpartum 1,3,5 d. Results The expression levels of serum cytokines（ IL- 6,CRP and PCT） of observation group at different time points were significantly higher than those of control group（ P〈0. 05）,while the expression levels of AT- Ⅲ was significantly lower than that of control group（ P〈0. 05）. The MDA,MPO of observation group at different time points were significantly higher than those of the control group（ P〈0. 05）,while the TAC,SOD were significantly lower than those of the control group（ P〈0. 05）. With the illness of puerperal infection aggravating,the expression levels of serum IL- 6,CRP and the PCT,MDA,MPO increased（ P〈0. 05）,while the expression levels of AT- Ⅲand TAC,SOD gradually reduced（ P〈0. 05）. Conclusion The dynamic monitoring of serum cytokines and the oxidation resistance indexes is helpful to judge the severity of the puerperal infection condition,and it has a certain clinical value.