妊娠晚期GBS感染对阴道微生态和IL-6/p-STAT3/p-AKT信号通路及母婴结局的影响  

Influence of GBS infection during late pregnancy on vaginal microecology,IL-6/p-STAT3/p-AKT signaling pathways and mother-infant outcomes

作　　者：林丽萍 张美龄 王慧静[1] LIN Li-ping;ZHANG Mei-ling;WANG Hui-jing(Haikou Maternal and Child Health Hospital,Haikou,Hainan 570203,China)

机构地区：[1]海口市妇幼保健院产科,海南海口570203

出　　处：《中华医院感染学杂志》2023年第18期2841-2845,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生健康行业科研项目(18A200143)。

摘　　要：目的探究妊娠晚期B族链球菌(GBS)感染对阴道微生态、白细胞介素-6(IL-6)/磷酸化转录信号转导子及激活子3(p-STAT3)/磷酸化蛋白激酶B(p-AKT)信号通路及母婴结局的影响.方法选取2020年1月-2022年12月海口市妇幼保健院经门诊或住院部产前生殖道分泌物检测GBS妊娠晚期孕妇为研究对象,其中180例GBS阳性孕妇为感染组,180例GBS阴性孕妇为对照组.比较两组阴道微生态及阴道分泌物IL-6、p-STAT3、p-AKT表达,并追踪母婴结局.结果感染组阴道pH值≥4.6、阴道清洁度Ⅲ~Ⅳ度、Nugent评分4~6分及7~10分占比均高于对照组(P<0.05);感染组阴道分泌物IL-6、p-STAT3、p-AKT表达均高于对照组(P<0.05);感染组胎膜早破、绒毛膜羊膜炎、产褥感染发生率22.78%、7.22%、9.44%,均高于对照组的5.56%、1.67%、3.89%(P<0.05),早产儿、新生儿窒息、病理性黄疸发生率25.56%、16.11%、15.56%,均高于对照组的9.44%、8.89%、8.33%(P<0.05).结论妊娠晚期孕妇GBS感染可导致阴道微生态异常、IL-6/p-STAT3/p-AKT信号通路表达增强,且与母婴不良结局有关.OBJECTIVE To explore the influence of group B Streptococcus(GBS)infection on vaginal microecology,interleukin-6(IL-6)/phosphorylated signal transducer and activator of transcription 3/phosphorylated protein kinase B(p-STAT3/p-AKT)signaling pathways and mother-infant outcomes.METHODS The pregnant women with GBS infection in late trimester of pregnancy who received genital tract secretions test in outpatient department or inpatient department of Haikou Maternal and Child Health Hospital from Jan 2020 to Dec 2022 were recruited as the research subjects,180 pregnant women who were tested positive for GBS were assigned as the infection group,and 180 pregnant women who were tested negative for GBS were assigned as the control group.The vaginal microecological state and expression levels of IL-6,p-STAT3 and p-AKT in vaginal secretions were compared between the two groups,and the mother-infant outcomes were tracked.RESULTS The percentages of the pregnant women with vaginal pH value no less than 4.6,Ⅲ~Ⅳdegree of vaginal cleanliness,Nugent score ranging from 4 to 6 points and from 7 to 10 points were higher in the infection group than in the control group(P<0.05).The expression levels of vaginal secretion IL-6,p-STAT3 and p-AKT of the infection group were higher than those of the control group(P<0.05).The incidence rates of premature rupture of membranes,chorioamnionitis and puerperal infection of the infection group were respectively 22.78%,7.22%and 9.44%,higher than 5.56%,1.67%and 3.89%of the control group(P<0.05);the incidence rates of preterm delivery,neonatal asphyxia and pathologic jaundice of the infection group were respectively 25.56%,16.11%and 15.56%,higher than 9.44%,8.89%and 8.33%of the control group(P<0.05).CONCLUSION The GBS infection may result in abnormal vaginal microecological state and increase the expressions of IL-6/p-STAT3/p-AKT signaling pathways in the pregnant women during late pregnancy,which is associated with the mother-infant outcomes.

关 键 词：妊娠晚期 B族链球菌 阴道微生态 白细胞介素-6 磷酸化转录信号转导子 激活子3/磷酸化蛋白激酶B 母婴结局 

分 类 号：R714.25[医药卫生—妇产科学]