孕妇阴道GBS检测联合胎儿脐带血CD64指数对胎膜早破新生儿感染的预测价值  

Predictive value of vagina GBS detection in pregnant women combined with fetal cord blood CD64 index for neonatal infection with premature rupture of membranes

作　　者：黄彬彬 刘海凤 HUANG Bin-bin;LIU Hai-feng(Department of Obstetrics and Gynecology,416 Hospital of Nuclear Industry,the Second Affiliated Medical Hospital of Chengdu Medical College,Chengdu Sichuan 610000,China)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院妇产科,四川成都610000

出　　处：《临床和实验医学杂志》2025年第5期523-527,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省自然科学基金项目(面上项目)(编号:22NSFSC0619)。

摘　　要：目的研究胎膜早破新生儿感染检查中孕妇阴道B族链球菌(GBS)检测联合胎儿脐带血CD64指数的预测价值。方法回顾性选取2022年1月至2024年1月入成都医学院第二附属医院·核工业四一六医院的85例足月分娩胎膜早破新生儿,按照感染状况将新生儿划分为两组:观察组(感染,n=24)和对照组(未感染,n=61)。选取倾向性评分匹配法予以配对,24对成功匹配。比较两组孕妇或新生儿的一般资料,对临床特征与胎膜早破新生儿感染相关性予以分析,选取多因素Logistic回归分析对影响胎膜早破新生儿感染的因素进行分析,并通过列线图模型验证;同时选取受试者操作特征(ROC)曲线评估新生儿感染检查中CD64指数、GBS阳性诊断效能。结果观察组与对照组CD64指数、阳性污染、5 min Apgar评分<7分、产前使用抗菌药物、阴道指检次数、GBS阳性、绒毛膜羊膜炎、胎膜早破至分娩时间比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,CD64指数、阴道指检次数、GBS阳性、绒毛膜羊膜炎、胎膜早破至分娩时间均为胎膜早破新生儿感染的危险因素(P<0.05)。交互作用分析显示,观察组与对照组中GBS阳性、CD64指数发挥着正相加交互作用(P<0.05)。ROC曲线分析显示,胎膜早破新生儿感染评估中单一GBS阳性、CD64指数及2项联合的曲线下面积(AUC)依次为0.806、0.762、0.846。结论胎膜早破新生儿感染的影响因素有GBS阳性、CD64指数、阴道检查次数、绒毛膜羊膜炎及胎膜早破至分娩时间。胎膜早破新生儿感染检查中CD64指数与GBS联合检测预测价值高于单一检测。临床应加大监测及调控力度,以此减少感染。Objective To study the predictive value of fetal cord blood CD64 index combined with vagina group B streptococcus(GBS)detection in pregnant women in neonatal infection detection of premature rupture of membranes.Methods A total of 85 full-term premature rupture of membranes neonates admitted to the 416 Hospital of Nuclear Industry,the Second Affiliated Medical Hospital of Chengdu Medical College from January 2022 to January 2024 were retrospectively selected.According to the infection status,the neonates were divided into two groups:the observation group(infection,n=24)and the control group(uninfected,n=61).The propensity score matching method was selected to match,and 24 pairs were successfully matched.The general data of the two groups were compared,and the correlation between clinical features and premature rupture of membranes neonatal infection was analyzed.The infection factors of premature rupture of membranes newborns were analyzed by multivariate Logistic regression,and verified by nomogram model.At the same time,CD64 index and GBS positive diagnostic efficiency were evaluated by receiver operating characteristic(ROC)curve.Results CD64 index,positive contamination,5 min Apgar score<7,prenatal use of antibiotics,number of vaginal examination,positive GBS,chorioamniotic infection,premature rupture of membranes to delivery time were statistically significantly different between the observation group and the control group(P<0.05).The risk factors of premature rupture of membranes neonatal infection were CD64 index,number of vaginal tract examination,GBS positive,chorioamniotic infection,premature rupture of membranes to delivery time(P<0.05).Interaction analysis showed that GBS positive and CD64 index played a positive additive interaction between observation group and control group(P<0.05).ROC curve analysis showed that single GBS positive,CD64 index and the area under the curve(AUC)of the two combinations were 0.806,0.762 and 0.846,respectively.Conclusion The CD64 index combined with GBS is of high value i

关 键 词：胎膜早破 孕妇 新生儿感染 B族链球菌 CD64指数 预测价值 

分 类 号：R722.1[医药卫生—儿科]