产前发热孕妇新生儿脐血粒细胞Toll样受体水平对新生儿宫内感染的预测价值  

Value of Toll-like receptor in cord blood granulocytes of neonates of pregnant women with prenatal fever in prediction of neonatal intrauterine infection

作　　者：盛蕾[1] 张雪梅[2] 王晓云[1] SHENG Lei;ZHANG Xue-mei;WANG Xiao-yun(Jining No.1 People's Hospital,Jining,Shandong 272100,China;不详)

机构地区：[1]济宁市第一人民医院儿科,山东济宁272100 [2]济南市第四人民医院医院院感办公室,山东济南250031

出　　处：《中华医院感染学杂志》2022年第10期1573-1576,共4页Chinese Journal of Nosocomiology

基　　金：山东省卫生健康委科研基金资助项目(2019-235)。

摘　　要：目的 探究产前发热孕妇新生儿脐血粒细胞Toll样受体(Toll-like receptor, TLR)水平对新生儿宫内感染的预测价值。方法 选择2020年1月-2021年3月于济宁市第一人民医院分娩的106例产前发热孕妇为研究对象,根据其新生儿宫内感染情况分为感染组64例和非感染组42例。统计感染组新生儿病原学特点,比较感染组与非感染组基线资料、脐血炎症指标[白细胞介素-8(IL-8)、超敏C-反应蛋白(hs-CRP)]及脐血粒细胞TLR相关指标(TLR2 mRNA、TLR2蛋白、TLR4 mRNA、TLR4蛋白)水平。结果 产前发热孕妇新生儿宫内感染发生率为60.37%,感染病原主要为大肠埃希菌,占30.26%,感染组与非感染组脐血IL-8和hs-CRP水平比较差异无统计学意义;感染组TLR2 mRNA、TLR2蛋白、TLR4 mRNA表达水平均高于非感染组(P<0.05),TLR2 mRNA、TLR2蛋白、TLR4 mRNA表达水平对新生儿宫内感染的预测效能较高,曲线下面积(AUC)为0.823、0.802、0.806。结论 产前发热孕妇新生儿脐血粒细胞TLR水平对新生儿宫内感染的预测价值较高,可代替脐血炎症指标对其进行早期诊断。OBJECTIVE To explore the value of Toll-like receptor(TLR) in cord blood granulocytes of neonates of pregnant women with prenatal fever in prediction of neonatal intrauterine infection. METHODS A total of 106 pregnant women with prenatal fever who gave birth in the Jining No.1 People′s Hospital from Jan 2020 to Mar 2021 were recruited as the study objects and were divided into the infection group with 64 cases and the no infection group with 42 cases according to the status of neonatal intrauterine infection. The etiological characteristics of the neonates in the infection group were statistically analyzed. The baseline data and levels of cord blood inflammatory indexes [interleukin-8(IL-8), hypersensitive C-reactive protein(hs-CRP)] and cord blood granulocyte TLR-related indexes(TLR2 mRNA, TLR2 protein, TLR4 mRNA, TLR4 protein) were observed and compared between the infection group and the no infection group. RESULTS The incidence of neonatal intrauterine infection was 60.37% among the pregnant women with prenatal fever. Escherichia coli was the predominant species of pathogen causing the infection, accounting for 30.26%. There were no significant differences in the levels of cord blood IL-8 and hs-CRP between the infection group and the no infection group. The expression levels of TLR2 mRNA, TLR2 protein and TLR4 mRNA of the infection group were higher than those of the no infection group(P<0.05). The efficiencies of the TLR2 mRNA, TLR2 protein and TLR4 mRNA were high in prediction of the neonatal intrauterine infection, and the areas under curves(AUCs) were 0.823, 0.802 and 0.806, respectively. CONCLUSION The TLR in cord blood granulocytes of neonates of pregnant women with prenatal fever has high value in prediction of the neonatal intrauterine infection, and it can be used as an alternative of cord blood inflammatory indexes for early diagnosis.

关 键 词：产前发热 脐血粒细胞 TOLL样受体 新生儿宫内感染 预测 

分 类 号：R722.13[医药卫生—儿科]