胎膜早破孕妇血清炎性标志物变化､生殖道感染情况及羊膜腔感染危险因素分析

Analysis of serum inflammatory markers,genital tract infection rate and risk factors affecting intraamniotic infection in PROM pregnant women

目的研究胎膜早破(PROM)孕妇血清炎症标志物水平变化､生殖道感染情况及引起羊膜腔感染的可能相关因素,并分析引起PROM的危险因素。方法将2017年6月至2020年6月台州市中心医院收治的113例PROM患者纳入观察组,同期正常妊娠并分娩的120例孕产妇纳入对照组。比较两组血清炎性标志物[血管细胞黏附分子-1(VCAM-1)､C反应蛋白(CRP)]及下生殖道感染情况,并行单因素及多因素Logistic回归分析影响PROM的独立危险因素;分析PROM孕产妇的羊膜腔感染情况,分析血清炎性标志物､生殖道感染与羊膜腔感染的关系。结果观察组血清炎性标志物VCAM-1､CRP水平及下生殖道感染率均显著高于对照组(P<0.05);多因素Logistic回归分析显示,下生殖道感染､血清VCAM-1水平､血清CRP水平及双胎妊娠均是影响PROM的独立危险因素;统计发现,PROM合并羊膜腔感染者共31例,其血清VCAM-1水平､血清CRP水平及下生殖道感染率均显著高于非羊膜腔感染者(P<0.05)。结论下生殖道感染､血清炎性标志物水平升高及双胎妊娠是PROM发生的独立危险因素,且下生殖道感染及炎性标志物水平升高还可能是影响羊膜腔感染发生的因素之一。

Objective To analyze the changes in serum inflammatory markers,the incidence rate of genital tract infection,and risk factors affecting intraamniotic infection in pregnant women with premature rupture of membranes(PROM),and to screen the risk factors causing PROM.Methods A sample of 113 PROM women and 120 healthy pregnant women in Taizhou Central Hospital from June 2017 to June 2020 were enrolled,and set as observation group and control group,respectively.Serum inflammatory markers[vascular cell adhesion molecule-1(VCAM-1),C-reactive protein(CRP)]and the rate of lower genital tract infection were compared between groups.Univariate and multivariate Logistic regression analysis were performed to screen the independent factors affecting PROM.The intraamniotic infection rate was recorded.Then the relationship among serum inflammatory markers,genital tract infection and intraamniotic infection was analyzed.Results The levels of serum inflammatory markers VCAM-1 and CRP as well as the lower genital tract infection rate in observation group were significantly higher than those in control group(P<0.05).Multivariate Logistic regression analysis indicated that lower genital tract infection,serum VCAM-1,serum CRP and twin pregnancy were independent risk factors affecting PROM.31 PROM women had intraamniotic infection,and their VCAM-1,CRP levels and lower genital tract infection rate were significantly higher than those without intraamniotic infection(P<0.05).Conclusions Lower genital tract infection,abnormal increase of serum inflammatory markers and twin pregnancy are independent risk factors affecting PROM.Moreover,lower genital tract infection and elevated levels of inflammatory markers have certain impact on intraamniotic infection.