妊娠糖尿病对新生儿免疫功能的影响及预测新生儿感染性疾病的价值研究

Effect of gestational diabetes on neonatal immune function and value of predicting neonatal infectious diseases

目的分析妊娠糖尿病对新生儿免疫功能的影响及预测新生儿感染性疾病的价值。方法选取2018年5月至2019年5月在石家庄市第三医院分娩的152例孕母为妊娠糖尿病的新生儿(观察组)作为研究对象。另选择同期在石家庄市第三医院分娩的152例孕母为健康产妇的新生儿作为对照组。比较两组各项免疫功能指标水平,C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)的阳性率,羊水葡萄糖水平以及新生儿感染性疾病发生率,采用受试者工作特征曲线(ROC)分析羊水葡萄糖对新生儿感染性疾病的预测价值。结果观察组血清IgG、C3水平均明显低于对照组,差异具有统计学意义(P<0.05);观察组外周血CD3、CD4、CD4/CD8水平均明显低于对照组,CD8水平明显高于对照组,差异具有统计学意义(P<0.05);观察组血清CRP、IL-6和PCT的阳性率均明显高于对照组,差异具有统计学意义(P<0.05);两组羊水葡萄糖水平及新生儿感染性疾病发生率比较,差异具有统计学意义(P<0.05);经ROC分析,羊水葡萄糖预测新生儿感染性疾病的AUC为0.835,最佳截断值为1.57mmol/L。结论妊娠糖尿病降低新生儿免疫功能,增大感染性疾病发生风险,检测羊水葡萄糖水平预测感染性病理状况的效能较好。

Objective To analyze the effect of gestational diabetes on neonatal immune function and predict the value of neonatal infectious diseases.Methods 152 neonates with gestational diabetes(observation group)who delivered in the Third Hospital of Shijiazhuang from May 2018 to May 2019 were selected as the subjects.152 healthy newborns delivered in the Third Hospital of Shijiazhuang were selected as the control group.The levels of various immune function indexes,the positive rates of C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT),the level of amniotic fluid glucose and the incidence of neonatal infectious diseases were compared between the two groups.The predictive value of amniotic fluid glucose for neonatal infectious diseases was analyzed by receiver operating characteristic curve(ROC).Results Serum IgG and C3 levels in the observation group were significantly lower than those in the control group(P<0.05).The levels of CD3,CD4 and CD4/CD8 in peripheral blood of the observation group were significantly lower than those of the control group,and the level of CD8 was significantly higher than that of the control group(P<0.05).The positive rates of serum CRP,IL-6 and PCT in observation group were significantly higher than those in control group(P<0.05).There was statistical significance in the level of amniotic fluid glucose and the incidence of neonatal infectious diseases between the two groups(P<0.05).By ROC analysis,the AUC of amniotic fluid glucose for predicting neonatal infectious diseases was 0.835,and the best cutoff value was 1.57 mmol/L.Conclusions Gestational diabetes reduces the immune function of neonates and increases the risk of infectious diseases.Detection of amniotic fluid glucose level is effective in predicting infectious pathological conditions.