孕妇阴道B族链球菌检测联合胎儿脐带血中性粒细胞CD64指数预测胎膜早破新生儿感染的价值  

Role of Group B Streptococcus detection in pregnant women combined with fetal cord blood neutrophil CD64 index for predicting neonatal infection with premature rupture of membranes

作　　者：谭海燕[1] 蒋玉蓉[1] TAN Haiyan;JIANG Yurong(Department 1 of Obstetrics,Hunan Maternal and Child Health Care Hospital,Changsha 410000,Hunan,China)

机构地区：[1]湖南省妇幼保健院产一科,湖南长沙410000

出　　处：《检验医学》2024年第1期53-59,共7页Laboratory Medicine

基　　金：湖南省卫生健康委员会科研计划项目(202205025118)。

摘　　要：目的 探讨孕妇阴道B族链球菌(GBS)检测联合胎儿脐带血中性粒细胞CD64指数对胎膜早破(PROM)新生儿感染的预测价值,并分析其影响因素。方法 选取2022年3—12月湖南省妇幼保健院170例足月分娩PROM新生儿作为观察组,根据新生儿感染情况分为感染组(48例)和未感染组(122例)。比较新生儿一般资料,分析PROM新生儿感染与临床特征的关系。采用多因素Logistic回归分析评价PROM新生儿感染的影响因素;构建列线图模型,并进行验证。采用受试者工作特征(ROC)曲线评价GBS阳性、CD64指数判断新生儿感染的效能。结果 感染组和未感染组PROM到分娩时间、绒毛膜羊膜炎、GBS阳性、阴道指检次数、产前使用抗菌药物、5 min Apgar评分<7分、羊水污染、CD64指数差异均有统计学意义(P<0.05)。PROM到分娩时间、绒毛膜羊膜炎、GBS阳性、阴道指检次数、CD64指数是PROM新生儿感染的危险因素(P<0.05),这5项指标在列线图预测模型中的总分为294分,对应的感染风险为73.15%。交互作用分析结果显示,CD64指数、GBS阳性对感染组和未感染组具有正相加交互作用(P<0.001)。ROC曲线分析结果显示,CD64指数和GBS阳性单项检测和联合检测判断PROM新生儿感染的曲线下面积分别为0.763、0.807和0.847。结论 孕妇阴道GBS检测联合胎儿脐带血中性粒细胞CD64指数对PROM新生儿感染具有较高的预测价值。PROM到分娩时间、绒毛膜羊膜炎、阴道检查次数是导致PROM新生儿感染的危险因素,临床应重点关注,以降低感染风险。Objective To investigate the role of Group B Streptococcus(GBS)detection in pregnant women combined with fetal cord blood neutrophil CD64 index for predicting neonatal infection with premature rupture of membranes(PROM).Methods A total of 170 full-term PROM neonates in Hunan Maternal and Child Health Care Hospital from March 2022 to December 2022 were enrolled as observation group,and 170 full-term PROM neonates were classified into infected group(48 cases)and uninfected group(122 cases)according to neonatal infection.The general data of neonates were compared to analyze the relationship between neonatal PROM infection and clinical characteristics of neonates.The factors for neonatal PROM infection were analyzed by multivariant Logistic regression analysis.A line graph prediction model was constructed and verified.The predictive efficacy of GBS detection combined with fetal cord blood neutrophil CD64 index was evaluated by receiver operating characteristic(ROC)curve.Results The time from PROM to delivery,chorioamnionitis,GBS positivity,the number of vaginal finger examination,prenatal antibiotic usage,5 min Apgar score<7,amniotic fluid contamination and fetal cord blood neutrophil CD64 index had statistical significance between the 2 groups(P<0.05).The time from PROM to delivery,chorioamnionitis,GBS positivity,the number of vaginal finger examination and fetal cord blood neutrophil CD64 index were the risk factors for neonatal PROM infection(P<0.05).The total score of the above 5 indexes in the line graph prediction model was 294,corresponding to 73.15%of the risk of infection.The results of interaction analysis showed that fetal cord blood neutrophil CD64 index and GBS positivity had positive additive interaction on neonatal PROM infection(P<0.001).The areas under curves of fetal cord blood neutrophil CD64 index and GBS positivity single and combined determinations were 0.763,0.807 and 0.847,respectively.Conclusions The detection of GBS in pregnant women combined with fetal cord blood neutrophil CD64 index has

关 键 词：B族链球菌 中性粒细胞CD64 胎膜早破 新生儿感染 

分 类 号：R378.1[医药卫生—病原生物学]