脐血RANTES、CyPA与胎膜早破合并宫内感染产妇分娩的新生儿发生NBI的关系  

The relationship between umbilical cord blood RANTES,CyPA and the occurrence of NBI in neonates delivered by puerperant women with premature rupture of membranes combined with intrauterine infection

作　　者：刘远慧 李小玲 LIU Yuanhui;LI Xiaoling(Department of Obstetrics,Xiaogan Maternal and Child Health Hospital,Xiaogan,Hubei 432100,China)

机构地区：[1]湖北省孝感市妇幼保健院产科,湖北孝感432100

出　　处：《国际检验医学杂志》2025年第4期443-447,共5页International Journal of Laboratory Medicine

基　　金：湖北省卫生健康委科研项目(WJ2021M043)。

摘　　要：目的探讨脐血调节活化正常T细胞表达和分泌因子(RANTES)、亲环素A(CyPA)与胎膜早破(PROM)合并宫内感染(IAI)产妇分娩的新生儿发生新生儿脑损伤(NBI)的关系。方法选取2022年1月至2024年3月在该院进行分娩的PROM合并IAI产妇157例作为试验组。另选取同期该院健康产妇80例作为对照组。PROM合并IAI产妇分娩的新生儿根据是否发生NBI分为NBI组(61例)和非NBI组(96例)。检测脐血RANTES、CyPA水平,以PROM合并IAI产妇分娩的新生儿发生NBI为因变量,多因素非条件Logistic回归分析确定其影响因素,绘制受试者工作特征(ROC)曲线分析脐血RANTES、CyPA水平对PROM合并IAI产妇分娩的新生儿发生NBI的预测价值。结果与对照组分娩的新生儿比较,试验组分娩的新生儿脐血RANTES、CyPA水平升高,差异有统计学意义(P<0.05)。PROM类型、1 min阿普加评分、降钙素原(PCT)、C反应蛋白、RANTES、CyPA与PROM合并IAI产妇分娩的新生儿发生NBI有关(P<0.05)。PROM合并IAI产妇分娩的新生儿发生NBI的独立危险因素为1 min阿普加评分增加(P<0.05),独立保护因素为PCT升高、RANTES升高、CyPA升高(P<0.05)。ROC曲线分析结果显示,脐血RANTES、CyPA水平联合预测PROM合并IAI产妇分娩的新生儿发生NBI的曲线下面积为0.874,大于脐血RANTES、CyPA水平单独预测的0.787、0.791(Z=3.248、2.801,P=0.001、0.005)。结论脐血RANTES、CyPA对PROM合并IAI产妇分娩的新生儿发生NBI具有较高的预测效能。Objective To investigate the relationship between umbilical cord blood regulated upon activation normal T cell expressed and secreted(RANTES),cyclophilin A(CyPA)and neonatal brain injury(NBI)in neonates delivered by puerperant women with premature rupture of fetal membrane(PROM)and intrauterine infection(IAI).Methods A total of 157 puerperant women with PROM and IAI who gave birth in the hospital from January 2022 to March 2024 were selected as the experimental group.Another 80 healthy parturients were selected as the control group.Neonates delivered by puerperant women with PROM and IAI were divided into NBI group(61 cases)and non-NBI group(96 cases)according to whether or not NBI occurred.The levels of RANTES and CyPA in umbilical cord blood were detected.NBI in neonates delivered by puerperant women with PROM and IAI was used as the dependent variable,and the influencing factors were determined by multivariate Logistic regression analysis.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of umbilical cord blood RANTES and CyPA levels for NBI in neonates delivered by puerperant women with PROM and IAI.Results Compared with neonates delivered in control group,the levels of RANTES and CyPA in umbilical cord blood of neonates delivered in experimental group were increased,and the differences were statistically significant(P<0.05).PROM type,1 min Apgar score,procalcitonin(PCT),C-reactive protein,RANTES,CyPA were associated with NBI in the neonates delivered by puerperant women with PROM and IAI(P<0.05).The independent risk factors for NBI were increased Apgar score within 1 min(P<0.05),and the independent protective factors were increased PCT,RANTES and CyPA(P<0.05).ROC curve analysis results showed that the area under the curve of umbilical cord blood RANTES and CyPA combined to predict the occurrence of NBI in neonates delivered by puerperant women with PROM and IAI was 0.874,which was larger than the 0.787 and 0.791 predicted by umbilical cord blood RANTES and CyPA alone(Z=3.2

关 键 词：胎膜早破 宫内感染 调节活化正常T细胞表达和分泌因子 亲环素A 新生儿脑损伤 

分 类 号：R714.433[医药卫生—妇产科学]