B族链球菌感染胎膜早破孕妇宫颈阴道分泌物IGF-1的表达及与妊娠结局的关系  

Expression of IGF-1 in cervicovaginal secretions and its relationship with pregnancy outcomes in pregnant women with group B Streptococcus infection and premature rupture of membranes

作　　者：张碧慧[1] 朱晓宁 李艳[1] 苏芳[2] 卫小静 曹彩萍 Zhang Bihui;Zhu Xiaoning;Li Yan;Su Fang;Wei Xiaojing;Cao Caiping(Department of Obstetrics,Linfen People's Hospital,Linfen Shanxi 041000,China;Department of Reproductive Medicine,Linfen People's Hospital,Linfen Shanxi 041000,China;Department of Obstetrics and Gynecology,The First Affiliated Hospital of Linfen Vocational and Technical College,Linfen Shanxi 041000,China)

机构地区：[1]山西省临汾市人民医院产科,山西临汾041000 [2]山西省临汾市人民医院生殖医学科,山西临汾041000 [3]临汾职业技术学院第一附属医院妇产科,山西临汾041000

出　　处：《保健医学研究与实践》2024年第11期67-72,共6页Health Medicine Research and Practice

基　　金：山西省教育厅高等学校科技创新项目(2022L215)。

摘　　要：目的探讨B族链球菌(GBS)感染胎膜早破孕妇宫颈阴道分泌物胰岛素样生长因子-1(IGF-1)的表达水平及其与妊娠结局的相关性。方法选取2019年1月—2023年12月在临汾市人民医院接受孕检并分娩的600例GBS感染孕妇作为研究组,根据是否发生胎膜早破分为胎膜早破组(145例)和无胎膜早破组(455例)。根据妊娠结局将胎膜早破孕妇分为良好组(99例)与不良组(46例)。同时选取200例健康孕妇作为对照组。收集孕妇一般资料并检测孕妇宫颈阴道分泌物IGF-1水平及血清降钙素原(PCT)和C反应蛋白(CRP)水平。采用logistic回归分析GBS感染胎膜早破孕妇不良妊娠结局的影响因素。采用受试者工作特征(ROC)曲线分析IGF-1对GBS感染胎膜早破孕妇不良妊娠结局的预测价值。结果研究组与对照组孕妇的年龄、身体质量指数(BMI)、孕周、孕次、孕期体质量增长情况比较,差异均无统计学意义(P>0.05)。妊娠结局良好组与不良组孕妇的年龄、BMI、孕周、孕次、合并其他类型阴道炎、总产程、孕期体质量增长情况比较,差异均无统计学意义(P>0.05);妊娠结局良好组孕妇血清PCT和CRP水平低于不良组,差异均有统计学意义(P<0.05)。胎膜早破组和无胎膜早破组孕妇宫颈阴道分泌物IGF-1水平均低于对照组,血清PCT和CRP水平高于对照组,差异均有统计学意义(P<0.05);胎膜早破组孕妇IGF-1水平低于无胎膜早破组,血清PCT和CRP水平高于无胎膜早破组,差异有统计学意义(P<0.05)。妊娠结局良好组孕妇宫颈阴道分泌物IGF-1水平高于妊娠结局不良组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,宫颈阴道分泌物IGF-1是GBS感染胎膜早破孕妇不良妊娠结局的保护因素,血清PCT和CRP是GBS感染胎膜早破孕妇不良妊娠结局的危险因素(P<0.05)。GBS感染胎膜早破孕妇宫颈阴道分泌物IGF-1及血清PCT和CRP水平预测不良妊娠结局的曲线下面Objective To investigate the expression level of insulin-like growth factor-1(IGF-1)in cervicovaginal secretions and its correlation with pregnancy outcomes in pregnant women with Group B Streptococcus(GBS)infection and premature rupture of membranes(PROM).Methods A total of 600 pregnant women with GBS infection who underwent prenatal examinations and delivered at Linfen People's Hospital from January 2019 to December 2023 were selected as the study group.Based on the occurrence of PROM,they were divided into a PROM group(145 cases)and a non-PROM group(455 cases).The PROM group was further categorized into a favorable outcome group(99 cases)and an adverse outcome group(46 cases)based on pregnancy outcomes.Additionally,200 healthy pregnant women were selected as the control group.General data were collected,and levels of IGF-1 in cervicovaginal secretions,serum procalcitonin(PCT),and C-reactive protein(CRP)were measured.Logistic regression was used to analyze influencing factors for adverse pregnancy outcomes in GBSinfected PROM patients.Receiver operating characteristic(ROC)curves were employed to evaluate the predictive value of IGF-1 for adverse pregnancy outcomes.Results No statistically significant differences were observed between the study and control groups in age,body mass index(BMI),gestational weeks,parity,or gestational weight gain(P>0.05).Similarly,no significant differences were found between the favorable and adverse outcome groups in age,BMI,gestational weeks,parity,co-occurrence of other vaginal infections,total labor duration,or gestational weight gain(P>0.05).Serum PCT and CRP levels were significantly lower in the favorable outcome group than in the adverse outcome group(P<0.05).IGF-1 levels in cervicovaginal secretions were significantly lower in both the PROM and non-PROM groups compared to the con-trol group,while serum PCT and CRP levels were significantly higher(P<0.05).The PROM group had significantly low-er IGF-1 levels and higher PCT and CRP levels than the non-PROM group(P<0.05).IGF-1

关 键 词：B族链球菌感染 胎膜早破 胰岛素样生长因子-1 妊娠结局 影响因素 预测价值 

分 类 号：R714.4[医药卫生—妇产科学] R722.1[医药卫生—临床医学]