新生儿宫内感染性肺炎病原菌及LPS、SAA、PCT的诊断价值

Pathogenic bacteria of intrauterine pneumonia in newborns and diagnostic value of LPS,SAA and PCT

目的探讨新生儿宫内感染性肺炎的病原菌及脂多糖(LPS)、淀粉样蛋白A(SAA)、降钙素原(PCT)对其诊断价值.方法回顾性选取2021年2月-2023年1月在宁波明州医院进行分娩的96例产妇及发生宫内感染性肺炎的新生儿作为感染组,另外选取同期于医院进行分娩的124例产妇及未发生宫内感染性肺炎的新生儿作为非感染组,统计宫内感染性肺炎新生儿病原菌,比较两组血清LPS、SAA、PCT水平,分析新生儿发生宫内感染性肺炎的危险因素,采用受试者工作特征(ROC)曲线分析血清实验室指标对新生儿发生宫内感染性肺炎的诊断价值.结果感染性肺炎新生儿检出病原菌以肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌和表皮葡萄球菌为主;感染组血清LPS、SAA、PCT均高于非感染组(P<0.05);宫内窘迫、胎膜早破、破膜距离胎儿娩出时间、母亲产前发热、母亲合并妊娠期糖尿病均为新生儿发生宫内感染性肺炎的危险因素(P<0.05);血清LPS、SAA、PCT联合检测对新生儿发生宫内感染性肺炎的曲线下面积(AUC)值和敏感度均高于三者单独检测(P<0.05).结论肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌、表皮葡萄球菌为宫内感染性肺炎新生儿主要感染病原菌种类,可引起患者血清LPS、SAA、PCT水平升高,其易感因素较多,且血清LPS、SAA、PCT联合检测可提高对新生儿发生宫内感染性肺炎的诊断价值.

OBJECTIVE To investigate the pathogenic bacteria of neonatal intrauterine pneumonia and the diagnostic value of lipopolysaccharide(LPS),amyloid A(SAA),and procalcitonin(PCT).METHODS Totally 96 cases of mothers who delivered in Ningbo Mingzhou Hospital and their newborns with intrauterine infectious pneumonia from Feb.2021 to Jan.2023 were retrospectively selected as the infection group,and the 124 cases of mothers who delivered in the hospital during the same period and their newborns without intrauterine infectious pneumonia were selected as the non-infection group,the pathogenic bacteria of the newborns with intrauterine infectious pneumonia were counted,the levels of serum lipopolysaccharide(LPS),amyloid A(SAA)and procalcitonin(PCT)were compared between the two groups,and the risk factors for neonatal intrauterine infection pneumonia were analyzed,and the diagnostic value of serum laboratory indicators for neonatal intrauterine infection pneumonia was analyzed by using receiver's operating characteristics(ROC)curve.RESULTS Klebsiella pneumoniae,Pseudomonas aeruginosa,Staphylococcus aureus and Staphylococcus epidermidis were the main pathogens of neonatal infection with infectious pneumonia.The levels of LPS,SAA and PCT in the infection group were higher than those in the non-infecrion group(P<0.05).Intrauterine distress,premature rupture of membranes,long time from fetal delivery to rupture of membranes,maternal prenatal fever,maternal gestational diabetes mellitus were all independent risk factors for neonatal intrauterine pneumonia(P<0.05).The area under the curve(AUC)value and sensitivity of serum LPS,SAA and PCT combined detection for intrauterine pneumonia in neonates were higher than those of the three detection alone(P<0.05).CONCLUSION Klebsiella pneumoniae,Pseudomonas aeruginosa,Staphylococcus aureus and Staphylococcus epidermidis were the main pathogens of intrauterine infectious pneumonia in newborns,which could cause elevated levels of serum LPS,SAA and PCT,with a large number of susceptible factors,and the combination of serum LPS,SAA and PCT could improve the diagnostic value of neonatal intrauterine infection pneumonia.