降钙素原、C-反应蛋白与妊娠晚期B族链球菌感染状态的关系

The relationship between procalcitonin,C-reactive protein and group B streptococcal infection in late pregnancy

目的探讨血清降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)水平在妊娠晚期B族链球菌(group B streptococcus,GBS)阳性孕妇感染状态中的判断价值。方法选取2018年4月至2019年12月在华北理工大学附属医院分娩的妊娠晚期GBS阳性孕妇190例为研究对象,其中GBS带菌46例(GBS带菌组)、GBS亚临床感染120例(GBS亚感染组)、绒毛膜羊膜炎24例(GBS羊膜炎组);选择同期在我院分娩的正常妊娠晚期孕妇20例为正常组。待研究对象分娩后,取母体肘静脉血,采用电化学发光法检测血清CRP、PCT水平,分析每组孕妇血清CRP、PCT水平变化。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析CRP、PCT对妊娠晚期GBS阳性孕妇感染状态的诊断效能。结果GBS带菌组孕妇血清CRP水平升高,差异有统计学意义(P<0.05),PCT无明显差异;GBS亚感染组和GBS羊膜炎组孕妇血清PCT和CRP均升高,差异均有统计学意义(P<0.05)。与GBS羊膜炎组孕妇血清PCT和CRP相比较,GBS带菌组和GBS亚感染组孕妇血清PCT和CRP均降低,差异均有统计学意义(P<0.05)。与GBS亚感染组孕妇血清PCT和CRP相比较,GBS带菌组孕妇血清PCT和CRP均降低,差异有统计学意义(P<0.05)。GBS阳性孕妇血清中PCT检测的AUC分别为0.165、0.632、0.988,血清中CRP检测的AUC分别为0.168、0.687、0.934,其中血清PCT和CRP在GBS羊膜炎的诊断效能最高;GBS亚感染次之;GBS带菌的诊断效能相对最低。结论妊娠晚期GBS感染孕妇血清中PCT、CRP含量对GBS羊膜炎的预测有一定的价值,能够作为GBS阳性孕妇感染状态的早期诊断指标。

Objective To investigate the value of serum procalcitonin(PCT)and C-reactive protein(CRP)levels in the infection status of group B streptococcus(GBS)positive pregnant women in late pregnancy.Methods 190 cases of GBS positive pregnant women who gave birth in Affiliated Hospital of North China University of Technology from April 2018 to December 2019 were included in the study,including 46 cases of GBS carrier(GBS carrier group)and 120 cases of GBS subclinical infection(GBS sub-infection group),24 cases of chorioamnionitis(GBS amnionitis group);20 cases of normal late pregnancy pregnant women who gave birth in our hospital during the same period were selected as the normal group.After the study subjects gave birth,the maternal cubital venous blood was taken,and the serum CRP and PCT levels were detected by electrochemiluminescence method,and the changes in the serum CRP and PCT levels of each group of pregnant women were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of CRP and PCT on the infection status of GBS positive pregnant women in late pregnancy.Results The serum CRP levels of pregnant women in the GBS carrier group increased,and the difference was statistically significant(P<0.05),and there was no significant difference in PCT;the serum PCT and CRP of pregnant women in the GBS sub-infection group and the GBS amnitis group increased,and the differences were statistically significant(P<0.05).Compared with the serum PCT and CRP of pregnant women in the GBS amnionitis group,the serum PCT and CRP of pregnant women in the GBS carrier group and the GBS sub-infected group were lower,and the differences were statistically significant(P<0.05).Compared with the serum PCT and CRP of pregnant women in the GBS sub-infected group,the serum PCT and CRP of pregnant women in the GBS carrier group decreased,and the differences were statistically significant(P<0.05).The AUC of PCT detection in the serum of GBS-positive pregnant women were 0.165,0.632,0.988,respectively,and the AUC of CRP detection in the serum were 0.168,0.687,0.934,respectively.Among them,serum PCT and CRP had the highest diagnostic efficiency in GBS amnionitis;GBS sub-infection was the second;The diagnostic efficiency of GBS carrier is relatively low.Conclusion The levels of PCT and CRP in the serum of GBS-infected pregnant women in the third trimester of pregnancy have certain value in predicting GBS amnionitis,and they can be used as early diagnostic indicators of the infection status of GBS-positive pregnant women.