探讨胎膜早破孕妇血清炎症水平与分娩期感染的关系及应用

To investigate the relationship between serum inflammation and intrapartum infection in pregnant women with premature rupture of membranes

目的 研究胎膜早破孕妇血清炎症水平和分娩期感染的关系及应用。方法 回顾性分析798胎膜早破孕妇的临床资料。根据破膜后24 h内进行血清C-反应蛋白(CRP)、白介素-6(IL-6)及降钙素原(PCT)检测的胎膜早破孕妇纳入破膜感染组(54例),在胎膜未破前检测的孕妇纳入未破膜感染组(28例)。另选取同期在破膜后24 h内检测的先兆流产孕妇为破膜对照组(51例)。按照在产程检测时间,其中第一产程前进行检测为第一产程前组(29例),对产妇破膜后第一产程及第二产程检测为第一、二产程组(27例)。根据是否存在炎症,将其分为有炎症(78例)、无炎症(720例)。比较各组的CRP、IL-6以及PCT水平,并统计炎症孕妇治疗和未治疗的新生儿感染情况。结果 破膜感染组的CRP、IL-6、PCT水平均高于未破膜感染组和破膜对照组(P<0.05)。第一产程前组CRP、IL-6水平均低于第一、二产程组(P<0.05)。两组PCT水平比较,差异无统计学意义(P>0.05)。798例胎膜早破孕妇发生60例新生儿感染,其中78例炎症产妇的新生儿有23例发生感染,720无炎症产妇的新生儿有37例发生感染,比较差异有统计学意义(P<0.05)。经治疗、未经治疗的炎症孕妇新生儿感染情况比较,差异无统计学意义(P>0.05)。结论 在胎膜早破孕妇中,监测CRP、IL-6、PCT水平对评估感染引起的胎膜早破具有重要意义,可为分娩期感染提供信息支持,以便于早期治疗,降低新生儿感染的发生率。

Objective To study the relationship between serum inflammation and intrapartum infection in pregnant women with premature rupture of membranes.Methods The clinical data of 798 pregnant women with premature rupture of membranes were analyzed retrospectively.Pregnant women with premature rupture of membranes who were detected by serum C-reactive protein(CRP),interleukin-6(IL-6) and procalcitonin(PCT) within 24 h after rupture of membranes were included in the broken membrane infection group(54 cases),and pregnant women who were detected before rupture of membranes were included in the unbroken membrane infection group(28 cases).Pregnant women with threatened abortion detected within 24 h after the same period were selected as the control group(51 cases).According to the detection time of labor,the detection before the first labor process was in the pre-first labor process group(29 cases),and the detection of the first and second labor stages after breaking the membrane was in the first and second labor stages group(27 cases).According to the presence or absence of inflammation,the patients were divided into those with inflammation(78 cases) and those without inflammation(720 cases).The levels of CRP,IL-6,and PCT were compared among the groups,and the incidence of neonatal infection in treated and untreated pregnant women with inflammation was measured.Results The levels of CRP,IL-6 and PCT in broken membrane infection group were higher than those in unbroken membrane infection group and broken membrane control group(P<0.05).Before the first stage of labor,the levels of CRP and IL-6 in the group were lower than those in the first and second stages of labor(P<0.05).There was no significant difference in PCT level between the two groups(P>0.05).Among the 798 pregnant women with premature rupture of membranes,60 newborns were infected,of which 23 were infected in 78 pregnant women with inflammation and 37 were infected in 720 pregnant women without inflammation,the difference was statistically significant(P<0.05).There was no significant difference in neonatal infection between treated and untreated pregnant women with inflammation(P>0.05).Conclusion In pregnant women with premature rupture of membranes,monitoring the levels of CRP,IL-6 and PCT is of great significance for the assessment of infection-induced premature rupture of membranes,which can provide information support for infection during childbirth,so as to facilitate early treatment and reduce the incidence of neonatal infection.