不同分娩方式对产褥感染患者TNF-α、IFN-γ、TGF-β及红细胞免疫状态的影响  

Effects of different delivery methods on levels of cytokines TNF-α,IFN-γ,TGF-β and erythrocyte immune status in patients with puerperal infection

作　　者：王秀娟[1] 王细先[1] 郭春海[2] WANG Xiu-juan;WANG Xi-xian;GUO Chun-hai(Department of Obstetrics and Gynecology,Beijing Aerospace General Hospital,Beijing 100076;Department of General Surgery,Beijing Chuiyangliu Hospital,Beijing 100022,China)

机构地区：[1]北京航天总医院妇产科,北京100076 [2]北京市垂杨柳医院普外科,北京100022

出　　处：《热带医学杂志》2021年第6期744-747,共4页Journal of Tropical Medicine

基　　金：国家卫生计生委医药卫生科技发展研究中心(W2015CAE024)。

摘　　要：目的探讨不同分娩方式对产褥感染患者肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、转化生长因子-β(TGF-β)及红细胞免疫因子[免疫黏附促进因子(FEER)、免疫黏附抑制因子(FEIR)、红细胞免疫复合物花环(RBC-ICR)]水平的影响。方法选取北京航天总医院2010年1月-2019年1月期间收治的剖宫产(剖宫产组)及阴道分娩(阴道分娩组)的产褥感染产妇各50例。比较两组产褥感染病原菌、发生部位分布、TNF-α、IFN-γ、TGF-β水平及红细胞免疫因子水平。结果阴道分娩组50例产褥感染者共分离出病原菌66株,剖宫产组50例产褥感染者共分离出病原菌64株,菌种分布基本一致;阴道分娩组会阴感染率显著低于剖宫产组,差异有统计学意义(P<0.05),两组呼吸系统和乳腺感染率差异无统计学意义(P>0.05);阴道分娩组产妇的TNF-α、IFN-γ及TGF-β水平均显著低于剖宫产组,差异均有统计学意义(P<0.05);阴道分娩组产妇的FEER水平显著高于剖宫产组,差异有统计学意义(P<0.05),FEIR及RBC-ICR水平显著低于剖宫产组,差异有统计学意义(P<0.05)。结论对比阴道分娩产妇,剖宫产产妇细胞因子TNF-α、IFN-γ、TGF-β及红细胞免疫因子FEIR、RBC-ICR水平更高,而红细胞免疫因子FEER水平更低,因此产后临床应给予充分监测与有效干预。Objective To investigate the effects of different delivery methods on the levels of cytokine tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),transforming growth factor-β(TGF-β),erythrocyte immune factor immune adhesion promoter(FEER),factor immune adhesion inhibitor(FEIR)and red blood cell immunocomplex receptor(RBC-ICR)in patients with puerperal infection. Methods 100 puerperal infection patients admitted to Beijing Aerospace General Hospital between January 2010 and January 2019 were divided into cesarean section group and vaginal delivery group,with50 cases each. The pathogens of puerperal infection,location distribution,TNF-α,IFN-γ,TGF-β levels and erythrocyte immune factor levels were compared between the two groups. Results 66 strains of pathogenic bacteria were isolated from50 cases of puerperal infection in the vaginal delivery group and 64 strains of pathogenic bacteria were isolated from 50 cases of puerperal infection in the cesarean section group. Perineal infection rate in the vaginal delivery group was significantly lower than that in the cesarean section group(P<0.05). There was no significant difference in respiratory system and breast infection rate between the two groups(P>0.05). The levels of TNF-α,IFN-γ and TGF-β in the vaginal delivery group were significantly lower than those in the cesarean section group(P<0.05). The level of FEER in the vaginal delivery group was significantly higher than that in the cesarean section group(P<0.05),and the levels of FEIR and RBCICR were significantly lower than those in the cesarean section group(P<0.05). Conclusion Compared with vaginal delivery women,cesarean section women had higher levels of cytokines TNF-α,IFN-γ,TGF-β and erythrocyte immune factors FEIR and RBC-ICR,while erythrocyte immune factor FEER levels was lower,so postpartum clinical should be given adequate monitoring and intervention.

关 键 词：阴道分娩 剖宫产 产褥感染 肿瘤坏死因子-α Γ-干扰素 转化生长因子-β 红细胞免疫因子 

分 类 号：R714.62[医药卫生—妇产科学]