摘要
目的探讨血清单核细胞趋化蛋白1(MCP-1)、可溶性Toll样受体4(sTLR4)、氧化型α1-抗胰蛋白酶(ox-AAT)水平在胎膜早破(PROM)合并绒毛膜羊膜炎(CAM)中的变化及对新生儿早发型败血症(EOS)的预测价值。方法选取郸城县妇幼保健院2020年11月至2022年12月收治的80例PROM产妇为研究对象,根据是否发生CAM将产妇分为CAM组(43例,轻度17例、中度14例、重度12例)和非CAM组(37例),根据新生儿是否发生EOS将产妇分为EOS(28例)和非EOS(52例)两个亚组。比较两组、EOS产妇和非EOS产妇宫缩前血清MCP-1、sTLR4、ox-AAT水平,分析宫缩前血清MCP-1、sTLR4、ox-AAT水平与合并CAM、CAM严重程度及发生EOS的相关性、新生儿发生EOS的影响因素以及对新生儿发生EOS的预测价值。结果与非CAM组相比,宫缩前CAM组血清MCP-1、sTLR4、ox-AAT水平较高,且轻度血清MCP-1、sTLR4、ox-AAT水平<中度<重度(P<0.05);EOS产妇宫缩前血清MCP-1、sTLR4、ox-AAT水平高于非EOS产妇(P<0.05);宫缩前血清MCP-1、sTLR4、ox-AAT水平与合并CAM、CAM严重程度、发生EOS呈正相关(P<0.05);Logistic回归分析显示,PROM产妇宫缩前血清MCP-1(>25.73 pg/mL)、sTLR4(>48.84 ng/mL)、ox-AAT(>2.46 ng/L)水平是新生儿发生EOS的危险因素(P<0.05);受试者工作特征(ROC)曲线显示,宫缩前PROM产妇血清MCP-1、sTLR4、ox-AAT水平联合预测新生儿发生EOS的AUC为0.806,最佳诊断敏感度、特异度分别为89.29%、71.15%(P<0.05)。结论血清MCP-1、sTLR4、ox-AAT水平在PROM合并CAM产妇中呈高表达,且联合应用时对于早期预测新生儿EOS发生具有较高敏感性与特异性。
【Objective】To investigate the changes of serum monocyte chemoattractant protein-1(MCP-1),soluble Toll-like receptor 4(sTLR4)and oxidative type alpha1-antitrypsin(ox-AAT)level in premature rupture of membranes(PROM)with chorioamnionitis(CAM)and their predictive value for neonatal early onset sepsis(EOS).【Methods】Eighty PROM pregnant women admitted to our hospital from November 2020 to December 2022 were selected as the study subjects.According to whether they were eligible for CAM,the pregnant women were divided into CAM group(43 cases,17 mild cases,14 moderate cases,12 severe cases)and non-CAM group(37 cases).According to whether the newborn had EOS,the pregnant women were divided into two subgroups:EOS(28 cases)and non-EOS(52 cases).The levels of serum MCP-1,sTLR4 and ox-AAT before uterine contraction were compared between the two groups,EOS and non-EOS pregnant women,and the correlation between the levels of serum MCP-1,sTLR4 and ox-AAT before uterine contraction and the severity of combined CAM,CAM and the occurrence of EOS,the influencing factors of the occurrence of EOS in newborns and the predictive value of EOS in newborns were analyzed.【Results】Compared with the non-CAM group,the levels of serum MCP-1,sTLR4 and ox-AAT were higher in the CAM group before uterine contraction,and the levels of serum MCP-1,sTLR4 and ox-AAT were lower in the mild group than in the moderate group(P<0.05).The levels of serum MCP-1,sTLR4 and ox-AAT in EOS women before uterine contraction were higher than those in non-EOS women(P<0.05).The levels of serum MCP-1,sTLR4 and ox-AAT before uterine contraction were positively correlated with the combination of CAM,the severity of CAM and the occurrence of EOS(P<0.05).Logistic regression analysis showed that the levels of serum MCP-1(>25.73 pg/mL),sTLR4(>48.84 ng/mL)and ox-AAT(>2.46 ng/L)were the risk factors for the occurrence of EOS in neonates of PROM women before uterine contraction(P<0.05).The working characteristic(ROC)curve of the subjects showed that the area under cu
作者
王文宁
倪银枝
魏楠楠
WANG Wenning;NI Yinzhi;WEI Nannan(Dancheng County Maternal and Child Health Hospital,Zhoukou,Henan 477150,China)
出处
《中国医学工程》
2023年第11期116-120,共5页
China Medical Engineering
