剖宫产后产褥感染患者细胞因子及红细胞免疫状态临床分析

Clinical analysis of cytokines and erythrocyte immune status of cesarean section patients with puerperal infection

目的观察剖宫产术后产褥感染产妇细胞因子水平和红细胞免疫状态及其与产褥感染的关系。方法选择济南市人民医院2016年2月-2018年2月收治的105例剖宫产术后发生产褥感染产妇为感染组,选择同期未发生产褥感染产妇101例为对照组。比较两组产妇细胞因子[白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-8(IL-8)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)]和红细胞免疫指标[免疫黏附促进因子(RFER)、免疫黏附抑制因子(FEIR)、红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)、协同肿瘤红细胞花环率(ATER)、直向肿瘤红细胞花环率(DTER)]表达水平,分析感染组不同白细胞水平上述指标的差异。结果感染组产妇血清IL-1β、IL-6、IL-8、IL-10、TNF-α、IFN-γ、hs-CRP、PCT、FEIR、RBC-ICR高于对照组(P<0.05),且随着WBC计数增加而升高(P<0.05),RFER、RBC-C3bRR、ATER、DTER低于对照组(P<0.05),且随着WBC计数增加而下降(P<0.05)。结论剖宫产术后产褥感染产妇炎性细胞因子水平明显增高,红细胞免疫功能显著下降,其水平与产褥感染、感染程度有关,可作为临床监测剖宫产产褥感染的重要指标。

OBJECTIVE To observe the levels of cytokines and erythrocyte immune status of the cesarean section patients with puerperal infection and analyze their relationship with the puerperal infection. METHODS Totally 105 puerpera who had puerperal infection after cesarean section and were treated in Jinan City People′s Hospital from Feb 2016 to Feb 2018 were assigned as the infection group, meanwhile, 101 puerpera who did not have puerperal infection were set as the control group.The levels of cytokines interleukin-1 β(IL-1 β), interleukin-6(IL-6), interleukin-8(IL-8), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), high-sensitivity C-reactive protein(hs-CRP) and procalcitonin(PCT) as well as erythrocyte immune indexes E rosette enhanced rate of RBC(RFER), E rosette inhibitive rate of RBC(FEIR), rosette rete of C3 b receptor of RBC(RBC-C3 bRR), rosette rate of immune compound of RBC(RBC-ICR), asspcoated tumor erythrocyte rosette(ATER) and direct tumor erythrocyte rosette(DTER) were compared between the two groups of puerpera;the levels of above indexes were observed and compared among the puerperal infection patients with different levels of white blood cell. RESULTS The levels of serum IL-1 β, IL-6, IL-8, IL-10, TNF-α, IFN-γ, hs-CRP, PCT, FEIR and RBC-ICR of the infection group were significantly higher than those of the control group(P<0.05), they were significantly elevated with the increase of WBC counts(P<0.05);the RFER, RBC-C3 bRR, ATER and DTER of the infection group were significantly lower than those of the control group(P<0.05), and they were significantly declined with the increase of WBC counts(P<0.05). CONCLUSION The levels of inflammatory cytokines of the cesarean section puerpera with puerperal infection are significantly elevated, while the erythrocyte immune function is significantly declined, the levels of the above indexes are associated with the severity of puerperal infection, which can be used as major indexes for monitoring of the cesareazn section puerpera with puerperal infection.