孕晚期B族链球菌感染顺产孕妇血清IL-6 CRP表达与新生儿结局的相关性

Correlation between serum IL-6 and CRP expressions and neonatal outcome in pregnant women of normal childbirth with group B streptococcus infection during late pregnancy

目的研究孕晚期B族链球菌(group B streptococcus, GBS)感染顺产孕妇血清白细胞介素-6(interleukin-6,IL-6)、C-反应蛋白(C-reactive protein, CRP)表达与新生儿结局的相关性。方法回顾性分析甘肃省妇幼保健院78例2017年4月—2019年4月孕晚期GBS感染顺产孕妇的临床资料,记录78例孕妇不良新生儿结局发生率并记为观察组,其余孕妇作为对照组。比较两组孕妇血清IL-6和CRP水平,分析孕妇血清IL-6与CRP判断新生儿结局的价值。结果 78例孕妇中不良新生儿结局24例,发生率30.77%,其中早产7例,新生儿肺炎6例,新生儿窒息5例,败血症4例,黄疸2例。观察组孕妇首次和末次血清IL-6、CRP水平显著高于对照组,差异均有统计学意义(P<0.05)。受试者工作曲线(receiver operating characteristic, ROC)分析结果显示确诊后首次IL-6(AUC=0.749,95%CI=0.637~0.862)和CRP(AUC=0.725,95%CI=0.595~0.854)、末次IL-6(AUC=0.722,95%CI=0.603~0.840)和CRP(AUC=0.713,95%CI=0.589~0.837)对判断新生儿结局具有一定价值(P<0.05)。首次血清因子(AUC=0.843,95%CI=0.740~0.945)与末次血清因子(AUC=0.854,95%CI=0.758~0.951)联合判断新生儿结局具有较高准确性(P<0.05)。结论监测孕晚期GBS感染顺产孕妇血清IL-6和CRP水平有助于判断新生儿结局,指导临床。

Objective To research the correlation between serum interleukin-6(IL-6) and C-reactive protein(CRP) expressions and neonatal outcome in pregnant women of normal childbirth with group B streptococcus(GBS) infection during late pregnancy.Methods From April 2017 to April 2019, the clinical data of 78 pregnant women of normal childbirth with GBS infection during late pregnancy from Gansu Provincial Maternal and Child Health Care Hospital were analyzed retrospectively, the pregnant women with adverse neonatal outcome were designed as observation group, the other pregnant women were designed as control group, the levels of serum IL-6 and CRP in the two groups were compared, the value of maternal serum IL-6 and CRP in prediction of neonatal outcome was analyzed.Results Among 78 pregnant women, 24 cases were found with adverse neonatal outcome, the incidence rate was 30.77%, including 7 cases of premature delivery, 6 cases of neonatal pneumonia, 5 cases of neonatal asphyxia, 4 cases of septicemia, and 2 cases of jaundice.The levels of serum IL-6 and CRP in the first and the last examinations in observation group were statistically significantly higher than those in control group(P<0.05).ROC curve results showed that the levels of serum IL-6(AUC=0.749, 95%CI=0.637-0.862) and CRP(AUC=0.725, 95%CI=0.595-0.854) in the first examination, the levels of serum IL-6(AUC=0.722, 95%CI=0.603-0.840)and CRP(AUC=0.713, 95%CI=0.589-0.837)in the last examination had certain value in predicting neonatal outcome(P<0.05).The accuracy of joint detection of serum cytokines in the first examination(AUC=0.843, 95%CI=0.740-0.945) and the last examination(AUC=0.854, 95%CI=0.758-0.951) was high(P<0.05).Conclusion Monitoring serum IL-6 and CRP levels in pregnant women of normal childbirth with GBS infection during late pregnancy can predict neonatal outcome and direct clinical treatment.