摘要
目的分析可溶性白细胞分化抗原14(sCD14)对胎膜早破(PROM)产妇围产期感染的诊断价值,为感染的早期诊断提供研究依据。方法选取2017年1月-2019年12月邢台市人民医院产科收治的295例PROM产妇作为研究对象。对围产期感染情况进行观察,并将产妇和新生儿分为感染组和未感染组。对两组产妇和新生儿的临床特征进行对比和分析;对两组产妇血清、脐带血清、新生儿血清中sCD14水平进行检测和对比,并采用受试者工作特征(ROC)曲线分析其诊断围产期感染的价值。结果48例新生儿发生围产期感染,感染率为16.27%。感染组围产期的孕周、出生体质量和出生1 min时Apgar评分分别为(36.36±3.38)周、(3.16±0.32)kg、(8.51±1.02)分均低于未感染组,合并急性呼吸窘迫综合征、早产占比为22.92%(11/48)、45.83%(22/48)高于对照组(P<0.05)。感染组产妇血清、脐带血清、新生儿血清中的sCD14水平分别为(55.66±8.06)ng/ml、(63.00±10.18)ng/ml、(59.44±8.49)ng/ml均高于未感染组(P<0.05)。产妇血清、脐血清、新生儿血清sCD14水平诊断围产期感染的ROC曲线下面积(Area under ROC curve,AUCROC)均有统计学意义(P<0.05),其中,脐带血清sCD14水平的AUCROC最高,为0.922,在Cut off值下,灵敏度和特异度分别为0.729和0.813。结论在发生围产期感染的PROM产妇和新生儿,可早期观察到母体静脉血、脐带血、新生儿静脉血中sCD14水平的上调,特别是脐带血sCD14水平对于辅助感染的早期诊断具有较高的价值,临床可考虑将其作为辅助指标用于提高感染的早期诊断效率。
OBJECTIVE To analyze the diagnostic values of soluble leukocyte differentiation antigen 14(sCD14)for perinatal infections of the puerpera with premature rupture of membranes(PROM),so as to provide research basis for early diagnosis of infections.METHODS Totally 295 women with PROM from Jan.2017 to Dec.2019 hospitalized in the department of Obstetrics of Xingtai people′s Hospital were selected as the research subjects.The occurrence of perinatal infections was observed,and the puerpera and the newborn were divided into the infection group and the non infection group.The clinical characteristics between the puerpera and the newborns in the two groups were compared and analyzed;the levels of sCD14 in the maternal serum,the umbilical serum and the neonatal serum between the two groups were detected and compared,and the receiver operating characteristic(ROC)curve was employed to analyze the diagnostic value of sCD14 for perinatal infections.RESULTS There were 48 cases of perinatal infections,the infection rate was 16.27%.The gestational weeks,the birth weight and the Apgar score at 1 minute of the infection group were(36.36±3.38)week,(3.16±0.32)kg,(8.51±1.02),respectively,significantly lower than those in the non infection group,and the proportions of acute respiratory distress syndrome and premature delivery of the perinatals in the infection group were 22.92%and 45.83%,respectively,significantly higher than those in the control group(P<0.05).The levels of sCD14 in the maternal serum,the umbilical serum and the neonatal serum in the infection group were(55.66±8.06)ng/ml,(63.00±10.18)ng/ml and(59.44±8.49)ng/ml,respectively,significantly higher than those in the non infection group(P<0.05).The areas under ROC curve(AUCROC)of sCD14 levels in the maternal serum,the umbilical serum and the neonatal serum in the diagnosis of perinatal infections were significant(P<0.05).Among them,the AUCROC of umbilical serum sCD14 level was the highest,which was 0.922.Under the Cutoff value,the sensitivity and specificity were 0.
作者
豆贝贝
申鑫鑫
李娜
刘质斌
李淑卫
DOU Bei-bei;SHEN Xin-xin;LI Na;LIU Zhi-bin;LI Shu-wei(Xingtai People's Hospital,Xingtai,Hebei 054100,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第11期1738-1742,共5页
Chinese Journal of Nosocomiology
基金
河北省医学科学研究重点课题计划基金资助项目(20170198)。
关键词
可溶性白细胞分化抗原14
胎膜早破
围产期感染
诊断
Soluble cluster of differentiation antigen 14
Premature rupture of membranes
Perinatal infection
Diagnosis
