妊高症产褥感染孕妇sFlt-1/PLGF与PLGF和PAPP-A水平及其危险因素  

sFlt-1/PLGF,PLGF and PAPP-A in pregnant women with pregnancy-induced hypertension and risk factors for puerperal infection

作　　者：杨雪梅 傅晓冬 钱莹 谢辉 倪瑶 YANG Xue-mei;FU Xiao-dong;QIAN Ying;XIE Hui;NI Yao(Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China;不详)

机构地区：[1]西南医科大学附属医院产科,四川泸州646000 [2]崇州市妇幼保健计划生育服务中心产科,四川崇州611230

出　　处：《中华医院感染学杂志》2024年第4期561-565,共5页Chinese Journal of Nosocomiology

基　　金：四川省科研基金资助项目(2021HF02130)。

摘　　要：目的探讨妊高症孕妇溶性血管内皮生长因子受体1(sFlt-1)/胎盘生长因子(PLGF)和PLGF及妊娠相关血浆蛋白-A(PAPP-A)及其产褥感染的危险因素.方法选取2020年3月—2023年3月西南医科大学附属医院及崇州市妇幼保健计划生育服务中心收治的妊高症孕妇产褥感染患者121例作为研究组,另选同期121例妊高症孕妇未发生产褥感染的临床资料作为对照组,并根据妊高症产褥感染患者妊娠结局分为良好组(93例)和不良组(28例);统计妊高症孕妇产褥感染的病原菌情况;比较两组临床资料,分析妊高症孕妇产褥感染的危险因素;比较不同妊娠结局产褥感染孕妇sFlt-1/PLGF、PLGF、PAPP-A水平;采用受试者工作特征(ROC)曲线分析sFlt-1/PLGF、PLGF、PAPP-A对妊高症产褥感染孕妇不良妊娠结局的预测价值.结果妊高症孕妇产褥感染病原菌以革兰阳性菌较多;产程、产后大出血、剖宫产、产前贫血、胎膜早破是妊高症孕妇产褥感染的危险因素(P<0.05);不良组血浆sFlt-1/PLGF、血清PAPP-A水平较良好组高(P<0.05),血浆PLGF较良好组低(P<0.05);绘制ROC曲线获得sFlt-1/PLGF、PLGF、PAPP-A单独及联合检测诊断妊高症产褥感染孕妇不良妊娠结局的曲线下面积(AUC)分别为0.775、0.751、0.724和0.820,联合诊断的AUC高于各项单独检测(P<0.05),且联合检测的敏感度和特异度为75.00%,78.50%.结论妊高症孕妇产褥感染病原菌以革兰阳性菌为主;sFlt-1/PLGF、PAPP-A在妊高症孕妇产褥感染不良妊娠结局患者中呈高表达,PLGF呈低表达;联合检测sFlt-1/PLGF、PLGF、PAPP-A有助于诊断产褥感染孕妇不良妊娠结局;产程、产后大出血、剖宫产、产前贫血、胎膜早破均是妊高症孕妇产褥感染的危险因素;临床可据此予患者针对性治疗及预防措施.OBJECTIVE To investigate the soluble vascular endothelial growth factor receptor-1(sFlt-1)/placental growth factor(PLGF),PLGF and pregnancy-related plasma protein-A(PAPP-A)in pregnant women with preg-nancy-induced hypertension(PIH)and their the risk factors for puerperal infection.METHODS A total of 121 pregnant women with pregnancy-induced hypertension with puerperal infection admitted to the Affiliated Hospital of Southwest Medical University and Chongzhou Maternal and Child Health and family Planning Service Center from Mar.2020 to Mar.2023 were selected as the study group,and 121 pregnant women with pregnancy-induced hypertension without puerperal infection during the same period were selected as the control group.According to the pregnancy outcome of pregnancy-induced hypertension patients with puerperal infection,they were divided into a good group(93 cases)and a bad group(28 cases).The distribution of pathogenic bacteria of puerperal infection in pregnant women with pregnancy-induced hypertension was analyzed.The clinical data of the two groups were compared,and the risk factors of puerperal infection in pregnant women with pregnancy-induced hypertension were analyzed.The levels of sFlt-1/PLGF,PLGF and PAPP-A were compared between pregnant women with pu-erperal infection of different pregnancy outcomes.The predictive value of sFlt-1/PLGF,PLGF and PAPP-A on the adverse pregnancy outcome in pregnant women with puerperal infection of pregnancy-induced hypertension was analyzed by receiver operating characteristic(ROC)curve.RESULTS The pathogens of puerperal infection in pregnant women with pregnancy-induced hypertension were predominantly gram-positive bacteria.The risk fac-tors of puerperal infection in pregnant women with pregnancy-induced hypertension were length of labor,postpar-tum hemorrhage,cesarean section,prenatal anemia and premature rupture of membranes(P<0.05).Plasma sFlt-1/PLGF and serum PAPP-A levels in the poor group were higher than those in the good group(P<0.05),while plasma PLGF was lower t

关 键 词：妊高症 产褥感染 病原菌 易感因素 可溶性血管内皮生长因子受体1 胎盘生长因子 妊娠相关血浆蛋白-A 妊娠结局 

分 类 号：R714.62[医药卫生—妇产科学]