围生期孕妇血清淀粉样蛋白A与降钙素原表达与B族链球菌宫内感染及妊娠结局的相关性

Correlation of serum amyloid A and procalcitonin expression in perinatal pregnant women with intrauterine infection of Group B Streptococcus and pregnancy outcome

目的 探究围生期孕妇血清淀粉样蛋白A(SAA)及降钙素原(PCT)表达与B族链球菌宫内感染及妊娠结局的相关性。方法 选取150例妊娠晚期B族溶血性链球菌(GBS)筛查阳性孕妇作为阳性组,另选取GBS阴性孕妇50例为对照组,阳性组再根据GBS感染状态分为GBS定植组、GBS亚临床感染组及GBS宫内感染组。比较阳性组与对照组入院时PCT及SAA水平。比较GBS定植组、GBS亚临床感染组、GBS宫内感染组三组SAA及PCT水平。ROC曲线分析SAA、PCT诊断围生期孕妇GBS感染程度的效能。比较阳性组与对照组的妊娠结局。比较GBS感染不同妊娠结局孕妇SAA及PCT水平。ROC曲线分析SAA、PCT诊断GBS感染孕妇不同妊娠结局的效能。结果 阳性组SAA及PCT水平均高于对照组(P<0.05)。3个亚组SAA及PCT水平差异有统计学意义(P<0.05)。SAA、PCT及两者联合诊断均对GBS感染程度有显著诊断价值(P<0.05)。阳性组胎膜早破及新生儿感染发生率显著高于对照组(P<0.05)。妊娠正常结局组SAA及PCT水平均显著低于妊娠不良结局组(P<0.05)。SAA、PCT及两者联合诊断对GBS感染患者妊娠结局有显著诊断价值(P<0.05),其中联合诊断效果优于PCT单独诊断。结论 围生期孕妇SAA与PCT能有效预测B族链球菌宫内感染程度及妊娠结局。

Objective To investigate the correlation of serum amyloid A(SAA)and procalcitonin(PCT)expression in perinatal pregnant women with intrauterine infection of group B Streptococcus and pregnancy outcome.Methods 150 group B Streptococcus(GBS)positive pregnant women in late pregnancy were selected as the positive group,and 50 GBS negative pregnant women were selected as the control group.According to the status of GBS infection,the positive group was divided into GBS colonization group,GBS subclinical infection group and GBS intrauterine infection group.PCT and SAA levels were compared between the positive group and the control group at admission.The levels of SAA and PCT in GBS colonization group,GBS subclinical infection group and GBS intrauterine infection group were compared.Receiver operator characteristic(ROC)curve was used to analyze the efficacy of SAA and PCT in diagnosing the degree of GBS infection in perinatal pregnant women.Pregnancy outcome was compared between positive group and control group.To compare the levels of SAA and PCT in pregnant women with GBS intrauterine infection of different pregnancy outcomes.ROC curve was used to analyze the efficacy of SAA and PCT in diagnosing different pregnancy outcomes in pregnant women infected with GBS.Results The levels of SAA and PCT in positive group were higher than those in control group(P<0.05).There were significant differences in the levels of SAA and PCT among the three subgroups(P<0.05).SAA,PCT and their combined diagnosis had significant diagnostic value on the degree of GBS infection(P<0.05).The incidence of premature rupture of membranes and neonatal infection in positive group was significantly higher than that in control group(P<0.05).The levels of SAA and PCT in normal pregnancy outcome group were significantly lower than those in adverse pregnancy outcome group(P<0.05).SAA,PCT and their combined diagnosis had significant diagnostic value for pregnancy outcomes in patients with GBS intrauterine infection(P<0.05),and the combined diagnosis was superior to the single diagnosis of PCT.Conclusion SAA and PCT in perinatal pregnant women can effectively predict the degree of intrauterine B Streptococcus infection and the pregnancy outcome.