摘要
目的分析孕产妇胎膜早破并发生殖道感染的危险因素,为临床预防提供参考依据。方法回顾性选取2022年11月-2023年1月杭州市妇产科医院收治的156例胎膜早破并发生殖道感染孕产妇为研究组,另随机选取156例同期胎膜早破未合并生殖道感染孕产妇为对照组,采用Lasso及Logistic回归分析孕产妇胎膜早破并发生殖道感染的危险因素,构建预测模型,受试者工作特征(ROC)曲线进行模型内部验证。结果Logistic分析结果显示,破膜时间长、有生殖道感染史、孕期阴道炎、产前贫血、免疫力低下及降钙素原(PCT)水平高、C-反应蛋白(CRP)水平高为孕产妇胎膜早破并发生殖道感染的危险因素(P<0.05),构建的预测模型:Logit(P)=-20.985+破膜时间×0.318+生殖道感染史×1.503+孕期阴道炎×1.658+产前贫血×1.561+免疫力低下×1.825+PCT水平×0.124+CRP水平×0.415,当Logit(P)>0.538时,曲线下面积(AUC)值为0.873,灵敏度为87.82%,特异度为90.38%。结论孕产妇胎膜早破并发生殖道感染的危险因素较多,包括破膜时间长、有生殖道感染史、孕期阴道炎、产前贫血、免疫力低下及高水平PCT、CRP,据此构建的模型预测价值较高。
OBJECTIVE To analyze the risk factors for genital tract infection in the puerpera with premature rupture of membranes(PROM)so as to provide guidance for clinical prevention.METHODS A total of 156 PROM puerpera who were complicated with genital tract infection and were treated in Hangzhou Hospital of Obstetrics and Gynecology from Nov 2022 to Jan 2023 were assigned as the study group,meanwhile,156 PROM puerpera who were not complicated with genital tract infection were chosen as the control group.Lasso and logistic regression analysis was performed for the risk factors for the genital tract infection in the PROM puerpera.The prediction model was established,and the internal verification of the model was carried out by means of receiver operating characteristic(ROC)curves.RESULTS The result of logistic regression analysis showed that long time of rupture,history of genital tract infection,gestational vaginitis,prenatal anemia,hypoimmunity,high level of procalcitonin(PCT)and high level of C-reactive protein(CRP)were the risk factors for the genital tract infection in the PROM puerpera(P<0.05).The established prediction model equation was as follows:Logit(P)=-20.985+timte of rupture×0.318+history of genital tract infection×1.503+gestational vaginitis×1.658+prenatal anemia×1.561+low immunity×1.825+PCT level×0.124+CRP level×0.415,when Logit(P)was greater than 0.538,the area under curve(AUC)was 0.873,with the sensitivity 87.82%,the specificity 90.38%.CONCLUSION There are a variety of risk factors for the genital tract infection in the PROM puerpera.The risk factors include the long time of rupture,history of genital tract infection,gestational vaginitis,prenatal anemia,low immunity,high level of PCT and high level of CRP.The model has high prediction model.
作者
贝丽君
周青雪
阮志强
章一娜
汪小敏
BEI Li-jun;ZHOU Qing-xue;RUAN Zhi-qiang;ZHANG Yi-na;WANG Xiao-min(Hangzhou Hospital of Obstetrics and Gynecology,Hangzhou,Zhejang 310000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第9期1409-1413,共5页
Chinese Journal of Nosocomiology
基金
浙江省自然科学基金(LTGY23H190004)。
关键词
孕产妇
胎膜早破
生殖道感染
危险因素
预测模型
Puerpera
Premature rupture of membrane
Genital tract infection
Risk factor
Prediction model
