孕母亚临床感染与早发型新生儿败血症的相关性分析

Correlation analysis of maternal subclinical infection and early onset neonatal sepsis

目的:探讨孕母亚临床感染和早发型新生儿败血症发生的相关性。方法:用随机病例对照研究方法,将600例孕妇按有无宫内感染分为病例组(亚临床宫内感染组)和对照组,抽取孕妇静脉血2ml,新生儿取脐血5ml测定CRP、PCT;按新生儿临床表现、血常规、CRP和PCT检测以及血培养情况,分败血症确诊组、临床败血症和正常新生儿3组,观察其新生儿感染情况。结果:病例组败血症确诊和临床败血症人数均明显多于对照组(P<0.05);母血和脐血CRP值均高于对照组,母血和脐血PCT阳性人数高于对照组(P<0.05);3组新生儿组间、母血和脐血CRP、PCT水平均有明显差异(P<0.05)。结论:孕母亚临床绒毛膜羊膜炎导致新生儿发生感染的风险增高,早发型新生儿败血症发病率增加。联合检测母血CRP、脐血CRP和PCT,有助于亚临床型绒毛膜羊膜炎与新生儿早发型败血症的早期诊治。

[Objective]To investigate the correlation between occurrence of maternal subclinical infection and early onset neonatal sepsis.[Method]Using the method of random case control study,600 pregnant women were divided into the case groups（ subclinical intrauterine infection group） and the control group by intrauterine infection. CRP（ C reactive protein） and PCT（ procalcitonin） in newborn umbilical blood and maternal venous were determined. According to neonatal clinical manifestations,blood routine,level of CRP and PCT and results of blood culture,each groupwere subdivided into three groups： confirmed sepsis,clinical sepsis and normal neonatesgroup. The neonatal infectionwas observed.[Result]The number of diagnosed septicemia and clinical sepsis in case group was significantly higher than the control group and the difference was statistically significant（ P〈0. 05）. Maternal and umbilical blood CRP values were higher than the control group. Numberof PCT positive was higher than the control group and the differences were statistically significant（ P〈0. 05）. The three groups of neonatal groups,maternal and umbilical cord blood CRP,PCT levels were significantly different（ P〈0. 05）.[Conclusion]Maternal subclinical chorioamnionitis leads to an increased risk of neonatal infection. Early onset neonatal septicemia incidence rate increase. The combined detection of maternalCRP and PCT in cord bloodcontribute to the early diagnosis and treatment of subclinical chorioamnionitis and early onset neonatal septicemia.