乳酸杆菌用于妊娠期宫内感染控制的临床效果及对妊娠结局的影响

Clinical effect of lactobacillus on intrauterine infection control during pregnancy and its influence on pregnancy outcome

目的观察乳酸杆菌用于妊娠期宫内感染控制的临床效果及对妊娠结局的影响。方法回顾性分析2018年5月-2019年6月慈利县人民医院收入院的妊娠中期孕产妇80例临床资料,根据是否接受过乳酸杆菌干预分为干预组和对照组,各40例。比较2组Th17/Treg与细胞因子[白细胞介素-17(IL-17)、白细胞介素-23(IL-23)、干扰素-γ(INF-γ)、肿瘤坏死因子-α(TNF-α)]水平,未足月胎膜早破发生情况与新生儿Apgar评分(分数越高则新生儿情况越好),阴道分泌物清洁度Ⅰ~Ⅱ度占比及妊娠期宫内感染发生情况。结果干预组Th17/Treg水平高于对照组,IL-17、IL-23、INF-γ及TNF-α水平均低于对照组(P均<0.01);干预组未足月胎膜早破发生率为7.50%,低于对照组的45.00%(χ^(2)=14.528,P=0.000);干预组新生儿Apgar评分为(9.32±0.41)分,高于对照组的(8.43±0.52)分(t=8.500,P=0.000);干预组阴道分泌物清洁度中Ⅰ~Ⅱ度占比为82.50%,高于对照组的22.50%(χ^(2)=28.872,P=0.000);干预组妊娠期宫内感染发生率为2.50%,低于对照组的20.00%(χ^(2)=4.507,P=0.034)。结论乳酸杆菌用于妊娠期宫内感染控制的临床效果较佳,对妊娠结局具有积极影响,可改善产妇阴道清洁度,降低妊娠期宫内感染发生率,降低未足月胎膜早破风险、提高新生儿评分,并可改善Th17/Treg水平与相关细胞因子水平,值得临床推广应用。

Objective To observe the clinical effect of Lactobacillus in the control of intrauterine infection during pregnancy and its influence on pregnancy outcome.Methods The clinical data of 80 cases of second trimester pregnant women admitted to Cili County People’s Hospital from May 2018 to June 2019 were retrospectively analyzed.According to whether they had received Lactobacillus intervention,they were divided into intervention group and control group,40 cases in each group.The levels of Th17/Treg,cytokines(IL-17,IL-23,TNF-α,INF-γ),incidence of preterm premature rupture of membranes and neonatal Apgar score were compared between the two groups(the higher the score,the better the neonatal condition).The proportion of vaginal secretion cleanlinessⅠ~Ⅱand intrauterine infection during pregnancy were compared between the two groups.Results The levels of Th17/Treg in the intervention group were higher than those in the control group,while the levels of IL-17,IL-23,INF-γand TNF-αin the intervention group were lower than those in the control group(all P<0.01);The incidence of preterm premature rupture of membranes in the intervention group was 7.50%,which was lower than 45.00%in the control group(χ^(2)=14.528,P=0.000);The Apgar score of newborns in the intervention group was(9.32±0.41),higher than(8.43±0.52)(t=8.500,P=0.000);In the intervention group,82.50%of the patients with vaginal discharge cleanliness of gradeⅠ~Ⅱwere higher than 22.50%in the control group(χ^(2)=28.872,P=0.000);The incidence of intrauterine infection in the intervention group was 2.50%,which was lower than 20.00%in the control group(χ^(2)=4.507,P=0.034).Conclusion The clinical effect of Lactobacillus in the control of intrauterine infection during pregnancy is good,which has a positive impact on the pregnancy outcome.It can improve the vaginal cleanliness of pregnant women,reduce the incidence of intrauterine infection during pregnancy,reduce the risk of preterm premature rupture of membranes,improve neonatal score,and improve Th17/Treg levels and related cytokine levels,which is worthy of clinical application.