T淋巴细胞亚群和细胞因子对瘢痕子宫剖宫产术后产褥感染预测价值

Predictive value of T lymphocyte subsets and cytokines for puerperal infection after cesarean section in scarred uterus

目的探讨T淋巴细胞亚群和细胞因子对瘢痕子宫剖宫产术后产褥感染的预测价值。方法选取2021年1月至2021年12月的在承德市中心医院行剖宫产术的瘢痕子宫产妇124例作为研究对象,根据其术后产褥感染情况分为产褥感染组(n=36)和非产褥感染组(n=88),比较两组的基本情况、T淋巴细胞亚群和细胞因子水平,采用多因素Logistic回归分析瘢痕子宫剖宫产术后产褥感染的独立危险因素,并以ROC曲线分析独立因素对瘢痕子宫剖宫产术后产褥感染的预测价值。结果产褥感染组的白介素-6(IL-6)、肿瘤坏死因子-a(TNF-a)、降钙素原(PCT)水平均高于非产褥感染组,差异有统计学意义(t=16.199、29.907、23.565,P<0.05)。产褥感染组的CD3+、CD4+水平低于非产褥感染组,CD8+高于产褥感染组,差异有统计学意义(t=2.465、3.275、6.998,P<0.05)。多因素Logistic回归分析显示IL-6、TNF-a、PCT、CD3+、CD4+、CD8+是瘢痕子宫剖宫产术后产褥感染的独立危险因素(P<0.05)。ROC曲线分析显示IL-6、TNF-a、PCT、CD3+、CD4+、CD8+对瘢痕子宫剖宫产术后产褥感染的预测价值AUC分别为0.746,0.711,0.745,0.824,0.835。结论T淋巴细胞亚群和细胞因子对瘢痕子宫剖宫产术后产褥感染均具有显著的预测价值。

Objective To investigate the predictive value of T lymphocyte subsets and cytokines for puerperal infection after cesarean section with scarred uterus.Methods 124 pregnant women with scarred uterus who underwent cesarean section in Chengde Central Hospital from January 2021 to December 2021 were selected as the research object.According to their postoperative puerperal infection,they were divided into the puerperal infection group(n=36)and the non-puerperal infection group(n=88).The basic situation,T lymphocyte subsets and cytokine levels between the two groups were compared.The independent risk factors of puerperal infection after cesarean section were analyzed by multivariate logistic regression,the ROC curve was used to analyze the predictive value of independent factors on puerperal infection after cesarean section.Results The levels of interleukin-6(IL-6),tumor necrosis factor-a(TNF-a)and procalcitonin(PCT)in the puerperal infection group were significantly higher than those in the non-puerperal infection group(t=16.199、29.907、23.565,P<0.05).The levels of CD3+and CD4+in the puerperal infection group were lower than those in the non-puerperal infection group,and CD8+was higher than those in the puerperal infection group(t=2.465、3.275、6.998,P<0.05).Multivariate logistic regression analysis showed that IL-6,TNF-a,PCT,CD3+,CD4+,CD8+were independent risk factors for puerperal infection after cesarean section(P<0.05).ROC curve analysis showed that the AUC of IL-6,TNF-a,PCT,CD3+,CD4+,CD8+in predicting puerperal infection after cesarean section were 0.746,0.711,0.745,0.824,0.835,respectively.Conclusion Both T lymphocyte subsets and cytokines have significant predictive value for puerperal infection after cesarean section with scarred uterus.