妊娠晚期生殖道单纯疱疹病毒感染抗病毒疗程中CCL8、CD4^(+)/CD8^(+)、TGF-β1动态变化及对分娩方式的指导价值  

Dynamic changes of CCL8,CD4^(+)/CD8^(+),TGF-β1 in the course of antiviral treatment for HSV infection in the reproductive tract during the third trimester of pregnancy and its guiding value for delivery methods

作　　者：徐月红[1] 沈丹丹 葛苗云[1] 张利萍 吕晶晶[1] XU Yue-hong;SHEN Dan-dan;GE Miao-yun;ZHANG Li-ping;LV Jing-jing(Department of Obstetrics,First People’s Hospital of Xiaoshan District,Hangzhou,Zhejiang 311200,China)

机构地区：[1]杭州市萧山区第一人民医院产科,浙江杭州311200

出　　处：《中国卫生检验杂志》2022年第6期730-734,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨妊娠晚期生殖道单纯疱疹病毒(HSV)感染抗病毒疗程中CC趋化因子配体8(CCL8)、T淋巴细胞(CD4^(+))/抑制性T淋巴细胞(CD8^(+))、转化生长因子-β1(TGF-β1)动态变化及对分娩方式的指导价值。方法选取2019年8月—2020年12月本院收治的120例妊娠晚期生殖道HSV感染患者,根据治疗后宫颈阴道分泌物HSV1/2 DNA及HSV抗体是否转阴分为非转阴组(n=21)、转阴组(n=99),比较2组基线资料、治疗前、治疗3 d后、治疗7 d后CCL8、CD4^(+)/CD8^(+)、TGF-β1,采用多因素Logistic回归方程分析是否转阴的相关影响因素,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析各时间点CCL8、CD4^(+)/CD8^(+)、TGF-β1预测转阴的效能,并比较不同CCL8、CD4^(+)/CD8^(+)、TGF-β1水平者转阴率。结果转阴组治疗3 d后、治疗7 d后的CCL8、TGF-β1低于非转阴组,CD4^(+)/CD8^(+)高于非转阴组(P<0.05);治疗3 d后、治疗7 d后各指标联合预测转阴的AUC分别为0.888、0.952,预测转阴的敏感度、特异度分别为94.95%、76.19%和96.97%、80.95%(P<0.05);CCL8、TGF-β1高水平者转阴率低于低水平者,CD4^(+)/CD8^(+)高水平者转阴率高于低水平者,差异有统计学意义(P<0.05)。结论妊娠晚期生殖道HSV感染抗病毒疗程中CCL8、CD4^(+)/CD8^(+)、TGF-β1呈动态变化,可作为预测抗病毒治疗转阴情况的有力依据,指导临床选择合适分娩方式。Objective To investigate the dynamic changes of CC chemokine ligand 8(CCL8),T lymphocytes(CD4^(+))/inhibitory T lymphocytes(CD8^(+)),transforming growth factor-β1 during the antiviral treatment of genital herpes simplex virus(HSV)infection in late pregnancy(TGF-β1)and the guiding value of delivery methods.Methods A total of 120 patients with reproductive tract HSV infection in the third trimester of pregnancy admitted to our hospital from August 2019 to December2020 were selected.They were divided into non-negative group(n=21)and negative group(n=99)according to whether HSV1/2 DNA of cervical and vaginal secretions and HSV antibody turned negative after treatment.The baseline data,CCL8,CD4^(+)/CD8^(+)and TGF-β1 of the two groups were compared before treatment,after treatment for 3 days,and after treatment for7 days.Multivariate Logistic regression equation was used to analyze the influencing factors of negative conversion.Receiver operating characteristic curve(ROC)and area under ROC(AUC)were used to analyze the efficacy of CCL8,CD4^(+)/CD8^(+)and TGF-β1 in predicting negative conversion at each time point,and the negative conversion rates of different levels of CCL8,CD4^(+)/CD8^(+)and TGF-β1 were compared.Results CCL8 and TGF-β1 were lower than the non-negative group;CD4^(+)/CD8^(+)were respectively higher than the non-negative group(P<0.05);after treatment for 3 days and 7 days,the AUC of the indicators combined to predict negative conversion were 0.888 and 0.952,respectively,and the sensitivity and specificity of predicting negative conversion were 94.95%,76.19%,96.97%,and 80.95%(P<0.05);The converted negative rates of those with high levels of CCL8 and TGF-β1 were lower than those with low levels,and the converted negative rate of those with high CD4^(+)/CD8^(+)levels was higher than those with low levels,with the above differences statistically significant(P<0.05).Conclusion CL8,CD4^(+)/CD8^(+),and TGF-β1 showed dynamic changes during the antiviral treatment of HSV infection in the reproductive tract

关 键 词：妊娠晚期 生殖道 单纯疱疹病毒 CC趋化因子配体8 转化生长因子-β1 分娩方式 转阴率 

分 类 号：R681.6[医药卫生—骨科学]