血清HIF-1α、GHb水平与妊娠期糖尿病剖宫产产妇术后感染风险的关系  

Relationship between serum HIF-1αand GHb levels and the risk of infection after cesarean section in pregnant women with gestational diabetes mellitus

作　　者：赵金梅 段艳芳 何文慧 ZHAO Jin-mei;DUAN Yan-fang;HE Wen-hui(Department of Gynaecology and Obstetrics,Cangzhou People's Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市人民医院妇产科,河北沧州061000

出　　处：《临床和实验医学杂志》2025年第5期519-523,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省2020年度医学科学研究课题计划项目(编号:20200291)。

摘　　要：目的探讨血清缺氧诱导因子1α(HIF-1α)、糖化血红蛋白(GHb)水平与妊娠期糖尿病(GDM)剖宫产产妇术后感染风险的关系。方法回顾性分析2022年8月至2023年8月沧州市人民医院收治的85例GDM剖宫产产妇的临床资料。根据产后是否感染将患者分为感染组(n=15)与非感染组(n=70)。比较两组的临床资料,包括年龄、体重指数、孕周、产次、手术时长、切口长度、阴道指检次数、胎膜是否早破、是否使用预防性抗菌药物、血红蛋白、HIF-1α、GHb、降钙素原(PCT)。采用多因素Logistic回归分析GDM剖宫产产妇术后发生感染的影响因素;采用受试者操作特征(ROC)曲线分析年龄、HIF-1α、GHb、PCT预测GDM剖宫产产妇术后发生感染的价值。结果两组体重指数、孕周、产次、切口长度、血红蛋白、白蛋白组间比较,差异均无统计学意义(P>0.05);感染组的年龄、手术时长≥1 h例数比例、阴道指检次数≥3次例数比例、胎膜早破例数比例、未使用预防性抗菌药物例数比例、HIF-1α、GHb、PCT分别为(33.14±3.71)岁、40.00%、46.67%、66.67%、(121.75±30.26)pg/mL、(7.47±1.75)%、(0.37±0.06)ng/mL,均显著高于非感染组[(28.16±2.95)岁、17.14%、21.43%、38.57%、(94.37±21.32)pg/mL、(6.36±1.22)%、(0.28±0.05)ng/mL],差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、手术时长≥1 h、阴道指检次数≥3次、胎膜早破、未使用预防性抗菌药、HIF-1α、GHb、PCT均是GDM剖宫产产妇术后发生感染的影响因素(P<0.05)。ROC曲线分析结果显示,年龄、HIF-1α、GHb、PCT预测GDM产妇剖宫产术后发生感染的曲线下面积分别为0.860、0.917、0.831、0.896,敏感度分别为0.933、0.867、0.800、0.733,且P<0.05。结论年龄、手术时长、阴道指检次数、胎膜早破、预防性抗菌药物、HIF-1α、GHb、PCT均是GDM产妇剖宫产术后发生感染的因素,HIF-1α、GHb、PCT高水平表达也提示感染高�Objective To investigate the relationship between serum hypoxia-inducible factor 1α(HIF-1α)and glycosylated hemoglobin(GHb)levels and the risk of infection after cesarean section in pregnant women with gestational diabetes mellitus(GDM).Methods The clinical data of 85 pregnant women with GDM who underwent cesarean section in Cangzhou People's Hospital from August 2022 to August 2023 were retrospectively analyzed.The patients were divided into the infection group(n=15)and the non-infection group(n=70)according to whether they were infected after the operation.The clinical data of the two groups were compared,including age,body mass index,gestational age,parity,length of operation,length of incision,number of vaginal examinations,premature rupture of membranes,use of prophylactic antibiotics,hemoglobin,HIF-1α,GHb,procalcitonin(PCT).The influencing factors of infection after cesarean section in women with GDM was analyzed using Multivariate Logistic regression.The value of age,HIF-1α,GHb and PCT in predicting infection after cesarean section in GDM women was analyzed using receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in body mass index,gestational age,parity,incision length,hemoglobin and albumin between the two groups(P>0.05).The age,the proportion of patients with operation time≥1 h,the proportion of patients with vaginal examination times≥3 times,the proportion of patients with premature rupture of membranes,the proportion of patients without prophylactic antibiotics,HIF-1α,GHb and PCT in the infection group were(33.14±3.71)years old,40.00%,46.67%,66.67%,(121.75±30.26)pg/mL,(7.47±1.75)%and(0.37±0.06)ng/mL,respectively,which were significantly higher than those in the non-infected group[(28.16±2.95)years,17.14%,21.43%,38.57%,(94.37±21.32)pg/mL,(6.36±1.22)%,(0.28±0.05)ng/mL],and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age,operation duration≥1 h,number of vaginal examinat

关 键 词：妊娠期糖尿病 剖宫产 术后感染 缺氧诱导因子1Α 糖化血红蛋白 

分 类 号：R714.2[医药卫生—妇产科学]