摘要
目的探讨降钙素原(Procalcitonin,PCT)、γ-干扰素(Interferon-γ,IFN-γ)联合转化生长因子-β(Transforming growth factor-β,TGF-β)对剖宫产产妇产褥感染的诊断价值及临床意义。方法选取2015年7月-2019年3月四川省妇幼保健院·四川省妇女儿童医院行剖宫产术后发生产褥感染的患者45例作为研究组,另选取同期行剖宫产术后未发生产褥感染的患者45例作为对照组。分析产褥感染产妇的病原菌分布;采用酶联免疫吸附(ELISA)法测定PCT、IFN-γ、TGF-β1水平;计算单个指标及联合检测的受试者工作特征(ROC)曲线下面积(AUC),分析最佳截断点、灵敏度、特异度、阳性预测值、阴性预测值等,评价检测PCT、IFN-γ、TGF-β1水平对剖宫产产后产褥感染的诊断效能。结果 45例剖宫产产褥感染产妇阴道及宫颈处共培养分离病原菌87株,其中革兰阴性菌29株占33.33%,革兰阳性菌14株占16.09%,支原体44株占50.57%,其中人支原体25株、解脲脲支原体18株;研究组产妇产后PCT、IFN-γ、TGF-β1分别为(1.57±0.98)μg/ml、(10.46±3.84)pg/L、(6.18±2.35)ng/L均高于对照组(P<0.001);单一指标检测ROC曲线下面积(AUC)低于联合检测水平(AUC:0.821;95%CI:0.752~0.894)(P<0.05);单一指标检测灵敏度、特异性、阳性预测值、阴性预测值,均低于联合检测灵敏度(83.47%)、特异性(88.52%)、阳性预测值(90.31%)、阴性预测值(87.92%)(P<0.05)。结论剖宫产产妇产褥感染的主要病原菌为支原体,临床应给予高度重视,展开积极有效治疗;联合检测PCT、IFN-γ、TGF-β1水平,对产褥感染的诊断具有重要的临床应用价值。
OBJECTIVE To investigate the diagnostic value and clinical significance of procalcitonin(PCT), interferon-γ(IFN-γ) combined with transforming growth factor-β(TGF-β) for puerperal infection of cesarean section women. METHODS Forty-five patients with puerperal infection after cesarean section admitted in Sichuan Maternal and Child Health Hospital and Sichuan Provincial Women and Children Hospital from Jul. 2015 to Mar. 2019 were selected as the study group, and 45 patients without puerperal infection after cesarean section were selected as the control group. The distribution of pathogenic bacteria in puerperium-infected women was analyzed. The levels of PCT, IFN-γ and TGF-β 1 were measured by enzyme-linked immunosorbent assay(ELISA). The area under the ROC curve(AUC) of the subjects with single index and joint detection was calculated, and the best cutoff point, sensitivity, specificity, positive predictive value and negative predictive value were analyzed, so as to evaluate the diagnostic efficacy of PCT, IFN-γ and TGF-β 1 in postpartum infection after cesarean section. RESULTS A total of 87 strains of pathogenic bacteria were isolated from vagina and cervix in 45 puerperal women with cesarean section infection, among which 29 strains of gram-negative bacteria accounted for 33.33%, 14 strains of gram-positive bacteria accounted for 16.09%, 44 strains of mycoplasma accounted for 50.57% including 25 strains of human mycoplasma and 18 strains of Ureaplasma urealyticum. The PCT, IFN-γ and TGF-β 1 in the study group were(1.57±0.98) μg/ml,(10.46±3.84) pg/L, and(6.18±2.35) ng/L, respectively, significantly higher than those in the control group(P<0.001). The area under ROC curve of single indicator was significantly lower than that of combined detection level(AUC: 0.821;95% CI: 0.752-0.894)(P<0.05);the sensitivity, specificity, positive predictive value and negative predictive value of single index were significantly lower than those of combined detection sensitivity(83.47%), specificity(88.52%), positive predictive value(90.31%) and negative predictive value(87.92%)(P<0.05). CONCLUSION Mycoplasma was the main pathogen of puerperal infection in cesarean section women, so we should pay more attention to it and carry out active and effective treatment. The combined detection of PCT, IFN-γ, TGF-β1 level has important clinical application in the diagnosis of puerperal infection.
作者
王雪
张恂
WANG Xue;ZHANG Xun(Sichuan Provincial Hospital for Women and Children,Chengdu,Sichuan 610045,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第4期572-576,共5页
Chinese Journal of Nosocomiology
关键词
产褥感染
剖宫产
降钙素原
Γ-干扰素
转化生长因子-Β1
Puerperal infection
Cesarean section
Procalcitonin
Interferon-γ
Transforming growth factor-β
