剖宫产产褥感染的病原体及SOD与MDA 和IFN-γ的预测价值  

Predictive value of SOD,MDA and IFN-γon puerperal infection in cesarean section and its pathogenic bacteria

作　　者：张秀丽[1] 何宏舸[1] 吴淑芬[1] 李战娜 王伟伟[1] ZHANG Xiu-li;HE Hong-ge;WU Shu-fen;LI Zhan-na;WANG Wei-wei(The Second Affiliated Hospital of Luohe Medical College,Luohe,Henan 462300,China)

机构地区：[1]漯河医学高等专科学校第二附属医院妇产科,河南漯河462300

出　　处：《中华医院感染学杂志》2022年第20期3151-3155,共5页Chinese Journal of Nosocomiology

基　　金：河南省科研基金资助项目(20191210)。

摘　　要：目的分析血清超氧化物歧化酶(SOD)、丙二醛(MDA)、干扰素γ(IFN-γ)对剖宫产产妇产褥感染的预测价值及其病原体。方法回顾性分析2018年4月-2020年12月漯河医学高等专科学校第二附属医院196例剖宫产产褥感染产妇(产褥感染组)临床资料,并纳入同期入院剖宫产且未发生产褥感染的196例产妇设为对照组(经年龄、孕周等1∶1匹配),比较两组血清SOD、MDA、IFN-γ水平,并使用受试者工作特征(ROC)曲线分析血清SOD、MDA、IFN-γ及其联合检测对剖宫产产褥感染的预测价值;记录产褥感染组病原体情况,根据检出病原菌分为支原体属感染组(支原体组)、细菌感染组(细菌组)及支原体属、细菌混合感染组(混合组),比较不同病原体感染组基线资料及血清SOD、MDA、IFN-γ水平,分析上述指标对产褥感染支原体属+细菌混合感染的预测价值。结果产褥感染组血清SOD低于对照组(P<0.05),血清MDA、IFN-γ均高于对照组(P<0.05);血清SOD、MDA、IFN-γ对剖宫产产褥感染均有较高预测价值(P<0.05),且3项指标联合检测预测价值最高,曲线下面积(AUC)为0.970(95%CI:0.957~0.984)。产褥感染组共检出病原菌247株,以革兰阴性菌为主。支原体感染38例,细菌感染116例,混合感染42例;混合组血清SOD水平低于支原体组及细菌组(P<0.05),血清MDA、IFN-γ水平则均高于支原体组及细菌组(P<0.05)。结论血清SOD、MDA、IFN-γ及其联合检测能辅助预测剖宫产产褥感染,积极检测上述指标对产褥感染防控工作具有重要意义。OBJECTIVE To analyze the predictive value of serum superoxide dismutase(SOD),malondialdehyde(MDA)and interferon-γ(IFN-γ)on puerperal infection in cesarean section women and their pathogens.METHODS The clinical data of 196 puerperae with cesarean section infection(puerperal infection group)in the Second Affiliated Hospital of Luohe Medical College from Apr.2018 to Dec.2020 were retrospectively analyzed,and another 196 puerperae who were admitted to the hospital for cesarean section during the same period and did not develop puerperal infection were included as the control group(age and gestational age at 1∶1 matching).The levels of serum SOD,MDA and IFN-γwere compared between the two groups,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum SOD,MDA,IFN-γand their combined detection on puerperal infection after cesarean section.The pathogenic bacteria in puerperal infection group were recorded and divided into mycoplasma infection group(mycoplasma group),bacterial infection group(bacterial group)and mixed mycoplasma and bacterial infection group(mixed group)according to the detected pathogenic bacteria.The baseline data and levels of serum SOD,MDA and IFN-γwere compared among the different pathogenic bacteria infection groups.The predictive value of the above indicators for mixed infection of mycoplasma+bacteria in puerperal infection was analyzed.RESULTS The level of serum SOD in puerperal infection group was lower than that in control group(P<0.05)while the levels of serum MDA and IFN-γwere higher than those in control group(P<0.05).Serum SOD,MDA and IFN-γhad high predictive value for puerperal infection after cesarean section(P<0.05),and the combined detection of the three indicators had the highest predictive value,with AUC of 0.970(95%CI:0.957-0.984).A total of 247 pathogenic bacteria were detected in puerperal infection group,of which Gram-negative bacteria accounted for the most.There were 38 cases in mycoplasma group,116 cases in bacterial group an

关 键 词：产褥感染 剖宫产 超氧化物歧化酶 丙二醛 干扰素Γ 病原体 预测价值 

分 类 号：R714.623[医药卫生—妇产科学]