B族链球菌感染孕妇妊娠晚期血清中性粒细胞明胶酶相关脂质运载蛋白、中性粒细胞淋巴细胞比值对新生儿结局的预测价值

Predictive value of serum neu-trophil gelatinase-associated lipocalin and neutrophil lymphocyte ratio in neonatal outcomes in pregnant women infected with group B streptococcus during the third trimester of pregnancy

目的探讨分析B族链球菌(GBS)感染孕妇妊娠晚期血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、中性粒细胞淋巴细胞比值(NLR)对新生儿结局的预测价值。方法回顾性选取2019年12月至2020年12月青岛市黄岛区中医医院收治的150例GBS感染的妊娠晚期孕妇作为研究对象,根据新生儿是否合并呼吸衰竭分为无呼吸衰竭组129例和呼吸衰竭组21例。检测孕妇血清NGAL、中性粒细胞计数、淋巴细胞计数,计算NLR,分析孕妇血清各项指标水平变化与新生儿结局的关系。结果呼吸衰竭组孕妇血清NGAL、NLR高于无呼吸衰竭组,差异有统计学意义(P<0.05)。血清NGAL预测新生儿呼吸衰竭的ROC曲线下面积为0.77(95%CI:0.628~0.812),敏感度和特异度分别为79.62%、71.28%;血清NLR预测新生儿呼吸衰竭的ROC曲线下面积为0.76(95%CI:0.735~0.834),敏感度和特异度分别为78.35%、71.46%;联合检测预测新生儿呼吸衰竭的ROC曲线下面积为0.81(95%CI:0.759~0.863),敏感度和特异度分别为82.37%、71.54%。结论GBS感染孕妇妊娠晚期血清NGAL、NLR水平异常升高与呼吸衰竭新生儿不良预后密切相关,其水平对预测新生儿呼吸衰竭具有重要临床价值。

Objective To investigate the predictive value of serum neu-trophil gelatinase-associated lipocalin(NGAL)and neutrophil lymphocyte ratio(NLR)for neonatal outcome in pregnant women infected with group B streptococcus(GBS)during the third trimester of pregnancy.Methods A total of 150 pregnant women infected with GBS in the third trimester of pregnancy admitted to Qingdao Huangdao District Traditional Chinese Medicine Hospital from December 2019 to December 2020 were retrospectively selected as research objects.According to whether the newborns were complicated with respiratory failure,they were divided into non respiratory failure group(129 cases)and respiratory failure group(21 cases).Detect serum NGAL,neutrophil count,lymphocyte count,calculate NLR,and analyze the relationship between changes in maternal serum indicators and neonatal outcomes.Results The serum NGAL and NLR of pregnant women of respiratory failure group were higher than those of non respiratory failure group,the differences were statistically significant(P<0.05).The area under the curve of ROC predicted by serum NGAL in newborns with respiratory failure was 0.77(95%CI:0.628-0.812),with a sensitivity and specificity of 79.62%and 71.28%,respectively.The area under the ROC curve predicted by serum NLR in newborns with respiratory failure was 0.76(95%CI:0.735-0.834),with sensitivity and specificity of 78.35%and 71.46%,respectively.The area under the curve of ROC for combined detection to predict neonatal respiratory failure was 0.81(95%CI:0.759-0.863),with sensitivity and specificity of 82.37%and 71.54%,respectively.Conclusion The abnormal increase of serum NGAL and NLR levels in pregnant women with GBS infection in the third trimester of pregnancy is closely related to the adverse prognosis of newborns with respiratory failure,and their levels have important clinical value in predicting neonatal respiratory failure.