未足月胎膜早破孕妇胎盘组织学绒毛膜羊膜炎发生情况及其影响因素  

Incidence of Placental Histology Chorioamnionitis in Pregnant Women with Preterm Premature Rupture of Membranes and Its Influencing Factors

作　　者：朱君 ZHU Jun(Puyang Hospital of Traditional Chinese Medicine,Puyang 457000,China)

机构地区：[1]濮阳市中医医院,河南濮阳457000

出　　处：《河南医学研究》2024年第15期2770-2774,共5页Henan Medical Research

摘　　要：目的探讨未足月胎膜早破(PPROM)孕妇胎盘组织学绒毛膜羊膜炎(HCA)发生情况及其影响因素。方法选取2019年3月至2022年8月濮阳市中医医院收治的145例PPROM孕妇为研究对象,依据产后胎盘病理检查结果分为HCA组(98例)、非HCA组(47例)。采用单因素、多因素logistic回归分析PPROM孕妇发生HCA的影响因素。分别构建logistic回归预测模型并进行验证。结果145例PPROM孕妇HCA发生率为67.59%;胎膜早破孕周较早、期待治疗时间延长、下生殖道感染、羊水粪染及血清C反应蛋白(CRP)、粒细胞集落刺激因子(G-CSF)、人β2防御素(HBD-2)、氧化型α1-抗胰蛋白酶(ox-AAT)、中性粒细胞弹性蛋白酶(NE)水平升高为HCA发生的危险因素(P<0.05);纳入胎膜早破孕周、期待治疗时间、下生殖道感染、羊水粪染、血清CRP水平作为模型1,纳入胎膜早破孕周、期待治疗时间、下生殖道感染、羊水粪染及血清CRP、G-CSF、HBD-2、ox-AAT、NE水平作为模型2,模型2预测HCA发生的曲线下面积大于模型1(P<0.05),且Hosmer-Lemeshow拟合优度检验显示该模型拟合效果良好。结论胎膜早破孕周较早、期待治疗时间延长、下生殖道感染、羊水粪染及血清CRP、G-CSF、HBD-2、ox-AAT、NE水平升高为PPROM孕妇发生HCA的危险因素,基于上述危险因素建立的logistic回归预测模型对HCA发生具有一定预测价值,医生可依据上述预测模型筛选高危人群,给予相应干预措施,以降低HCA发生风险。Objective To investigate the occurrence of placental histological chorioamnioitis(HCA)in pregnant women with preterm premature rupture of fetal membrane(PPROM)and the related influencing factors.Methods A total of 145 pregnant women with PPROM admitted to Puyang Hospital of Traditional Chinese Medicine from March 2019 to August 2022 were selected as the study objects,and were divided into HCA group(98 cases)and non-HCA group(47 cases)according to the pathological examination results of postpartum placenta.Univariate and multivariate logistic regression was used to analyze the influencing factors of HCA in pregnant women with PPROM.The logistic regression prediction model was constructed and verified respectively.Results The incidence of HCA in 145 pregnant women with PPROM was 67.59%.Early pregnancy week,prolonged expectant treatment time,lower reproductive tract infection,amniotic fluid fecal infection,and elevated levels of serum C-reactive protein(CRP),granulocyte-colony-stimulating factor(G-CSF),humanβ-defensin-2(HBD-2),oxidative type alpha1-antitrypsin(ox-AAT)and neutrophil elastase(NE)were the risk factor for the occurrence of HCA(P<0.05).The gestational week of premature rupture of membranes,expected treatment time,lower reproductive tract infection,amniotic fluid fecal contamination and serum CRP levels were included as model 1,and the gestational week of premature rupture of membranes,expected treatment time,lower reproductive tract infection,amniotic fluid fecal contamination,and serum CRP,G-CSF,HBD-2,ox-AAT and NE levels were included as model 2.The area under the curve of model 2 for predicting the occurrence of HCA was greater than that of model 1(P<0.05),and the Hosmer-Lemeshow goodness of fit test showed that the model had a good fitting effect.Conclusion Early gestational week of premature rupture of membranes,prolonged expectant treatment time,lower reproductive tract infection,amniotic fluid fecal staining and elevated serum CRP,G-CSF,HBD-2,ox-AAT and NE levels are risk factors for HCA in pregn

关 键 词：胎膜早破 胎盘组织学绒毛膜羊膜炎 LOGISTIC回归 预测模型 危险因素 

分 类 号：R714.1[医药卫生—妇产科学]