B族链球菌感染孕妇CCL-1、ASO、hs-CRP、PCT表达意义

Expressions of CCL-1,ASO,hs-CRP and PCT in pregnant women with group B Streptococcus infection and their significance

目的分析B族链球菌感染孕妇趋化细胞因子配体1(CCL-1)、抗链球菌溶血素O(ASO)、高敏C-反应蛋白(hs-CRP)、降钙素原(PCT)表达意义。方法选取2021年1月-2023年1月聊城市第二人民医院收治的89例B族链球菌感染孕妇为研究组,随机选取同期正常孕妇(无B族链球菌感染)96名为对照组。分析B族链球菌感染孕妇药敏结果,研究组、对照组阴道菌群、妊娠结局,研究组不同妊娠结局血清CCL-1、ASO、hs-CRP、PCT水平,绘制受试者工作特征(ROC)曲线分析其对研究组妊娠不良结局的预测价值。结果B族链球菌对氨苄西林、青霉素、头孢克洛、头孢曲松、利奈唑胺、头孢噻肟、万古霉素敏感。与对照组比较,研究组阴道酸碱度(pH)值>4.5、阴道清洁度Ⅲ~Ⅳ占比更高(P<0.05)。相比于对照组,研究组羊水污染、胎膜早破、早产、胎儿窘迫、新生儿感染等妊娠不良结局发生率更高(P<0.05)。妊娠不良结局组血清CCL-1、ASO、hs-CRP、PCT水平高于妊娠结局良好组(P<0.05)。分析血清CCL-1、ASO、hs-CRP、PCT对研究组妊娠不良结局的预测价值,曲线下面积(AUC)、敏感性、特异性均较高,联合检测为最高(P<0.05)。结论B族链球菌感染可影响妊娠期孕妇阴道菌群、妊娠结局,其对不同抗菌药物的耐药性不同,不良妊娠结局的发生提高血清CCL-1、ASO、hs-CRP、PCT水平,联合检测对其预测价值较高。

OBJECTIVE To explore the expressions of chemokine ligand 1(CCL-1),anti-streptolysin O(ASO),high-sensitivity C-reactive protein(hs-CRP)and procalcitonin(PCT)in the pregnant women with group B Streptococcus(GBS)infection and analyze the significance.METHODS A total of 89 pregnant women with GBS infection who were treated in Liaocheng Second People′s Hospital from Jan.2021 to Jan.2023 were assigned as the study group.Meanwhile,96 healthy pregnant women(without GBS infection)were chosen as the control group.The result of drug susceptibility testing for the pregnant women with GBS infection was analyzed.The vaginal flora and pregnancy outcomes were compared between the study group and the control group.The levels of serum CCL-1,ASO,hs-CRP and PCT were compared among the pregnant women with different pregnancy outcomes in the study group.Receiver operating characteristic(ROC)curves were drawn to analyze the values of the above indexes in prediction of adverse pregnancy outcomes of the study group.RESULTS GBS strains were sensitive to ampicillin,penicillin,cefaclor,ceftriaxone,linezolid,cefotaxime and vancomycin.The proportions of pregnant women with vaginal power of hydrogen(pH)value more than 4.5 and vaginal cleanliness ranging between gradeⅢand gradeⅣwere higher in the study group than in the control group(P<0.05).The incidence rates of adverse pregnancy outcomes such as amniotic fluid contamination,premature rupture of fetal membranes,premature delivery,fetal distress and neonatal infection were higher in the study group than in the control group(P<0.05).The levels of serum CCL-1,ASO,hs-CRP and PCT of the adverse pregnancy outcome group were higher than those of the favorable pregnancy outcome group(P<0.05).ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of the joint detection of the serum CCL-1,ASO,hs-CRP and PCT were higher than those of the single detection in prediction of the adverse pregnancy outcomes of the pregnant women in the study group(P<0.05).CONCLUSIONS The GBS infection may affect the vaginal flora and pregnancy outcomes of the pregnant women.The pregnant women with GBS infection vary in the drug resistance.The pregnant women with adverse pregnancy outcomes show the rise of serum CCL-1,ASO,hs-CRP and PCT.The joint detection of the above indexes has relatively high predictive value.