剖宫产后产褥感染sICAM-1与hs-CRP和LYM的临床意义  

The clinical significance of sICAM-1,hs-CRP and LYM in puerperal infection after cesarean section

作　　者：李欣[1] 杨夫艳[1] 金欣 马笑笑 张静[1] LI Xin;YANG Fu-yan;JIN Xin;MA Xiao-xiao;ZHANG Jing(The first people's hospital of lianyungang,lianyungang,Jiangsu 222002,China)

机构地区：[1]连云港市第一人民医院产科,江苏连云港222002

出　　处：《中华医院感染学杂志》2021年第18期2821-2825,共5页Chinese Journal of Nosocomiology

基　　金：江苏省妇幼健康科研基金资助项目(F201838)。

摘　　要：目的探讨可溶性细胞间黏附分子-1(sICAM-1)、超敏C-反应蛋白(hs-CRP)、淋巴细胞分数(LYM)在剖宫产后产褥感染中的表达变化及临床意义。方法选取2018年4月-2020年4月连云港市第一人民医院收治的83例剖宫产后产褥感染产妇作为研究组,并根据1:3比例选取249例剖宫产后未发生产褥感染者作为对照组。比较两组临床资料、术后1、3、5dsICAM-1、hs-CRP、LYM,采用Pesrson相关性分析各指标之间相关性,探讨上述指标与产褥感染的关系,并根据不同感染类型分为真菌感染、革兰阳性菌感染、革兰阴性菌感染,比较三者术后1、3、5d上述指标。结果两组产前贫血、胎膜早破、合并妊娠期并发症、白细胞计数比较,差异有统计学意义(P<0.05)。研究组术后3、5dsICAM-1、hs-CRP、LYM均高于对照组(P<0.05)。Pesrson相关性分析,sICAM-1与hs-CRP、LYM呈正相关,hs-CRP与LYM呈正相关(P<0.05)。术后3dsICAM-1、hs-CRP、LYM是剖宫产后产褥感染发生的影响因素(P<0.05);术后3、5dLYM:革兰阴性菌>革兰阳性菌>真菌,hs-CRP:革兰阳性菌>革兰阴性菌>真菌(P均<0.05)。结论sICAM-1、hs-CRP、LYM在剖宫产后产褥感染患者中过度上调,早期检测上述指标水平可为剖宫产后产褥感染诊断提供有效辅助手段,有助于指导临床区分感染病原菌类型,合理应用抗菌药物。OBJECTIVE To investigate the expression changes and clinical significance of soluble intercellular adhesion molecule-1(sICAM-1),high-sensitivity C-reactive protein(hs-CRP),lymphocyte fraction(LYM)in puerperal infection after cesarean section.METHODS A total of 83patients with puerperal infection after cesarean section admitted to the First People’s Hospital of Lianyungang from Apr.2018to Apr.2020were selected as the study group,and 249patients who did not develop puerperal infection after cesarean section were selected as the control group based on a 1:3ratio.The clinical data and sICAM-1,hs-CRP and LYM on 1d,3d,5dafter operation were compared between the two groups.Pesrson correlation analysis was used to analyze the correlation between the indicators,and the relationship between the above indicators and puerperal infections was explored.According to different types of infection,the patients were divided into fungal infections,gram-positive bacteria infections,and gram-negative bacteria infections.The above indicators of the three groups were compared on the 1st,3nd,and 5th day after surgery.RESULTS There were significant differences in prenatal anemia,premature rupture of membranes,complications during pregnancy,and white blood cell count between the two groups(P<0.05).The sICAM-1,hs-CRP,and LYM of the study group were significatly higher than those of the control group at 3and 5days after operation(P<0.05).Pesrson correlation analysis showed that sICAM-1was positively correlated with hs-CRP and LYM,and hs-CRP was positively correlated with LYM(P<0.05).SICAM-1,hs-CRP,and LYM were influencing factors for the occurrence of puerperal infection after cesarean section 3days after operation(P<0.05);On 3and 5days after operation,the LYM level in the Gram-negative bacteria infection group was significatly higher than that of Gram-positive bacterial infection group,and significatly higher than that of fungi infection group,hs-CRP:while the hs-CRP level in Gram-positive bacterial infection group was significatly higher

关 键 词：可溶性细胞间黏附分子-1 超敏C-反应蛋白 淋巴细胞分数 剖宫产 产褥感染 

分 类 号：R714.62[医药卫生—妇产科学]