摘要
目的研究细胞因子、红细胞免疫状态变化与产妇产褥期感染的相关性。方法选取2015年2月-2018年1月医院产褥期感染产妇96例为试验组,产褥期未感染产妇90例为对照组。比较两组产妇产褥感染时、治疗24h、72h、治疗结束时白细胞计数(WBC)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和红细胞免疫状态。采用Pearson分析产褥感染与血清细胞因子TNF-α、IL-6及红细胞免疫状态相关性。结果试验组产妇产褥感染时血清WBC计数、PCT、TNF-α、IL-6分别为(21.00±4.30)×109/L、(10.60±1.80)ng/ml、(218.00±53.00)pg/ml、(13.20±1.44)pg/ml,治疗24h(22.50±3.80)×109/L、(12.00±4.50)ng/ml、(276.00±82.00)pg/ml、(14.00±1.68)pg/ml,72h(15.50±2.40)×109/L、(7.10±3.30)ng/ml、(148.00±33.00)pg/ml、(11.20±1.34)pg/ml均高于对照组(P<0.05);治疗结束时两组产妇血清WBC计数、PCT、TNF-α、IL-6差异无统计学意义。产褥感染、治疗24h,试验组红细胞FEER为(23.50±3.10)%、(22.00±3.43)%低于对照组,FEIR、RBC-ICR为(35.20±3.20)%、(36.00±3.45)%和(11.40±1.52)%、(11.68±1.39)%高于对照组(P <0.05)。TNF-α、IL-6水平、血清WBC计数、PCT水平互相呈正相关(P<0.05)。FEER与FEIR、RBC-ICR水平、血清细胞因子TNF-α、IL-6水平呈负相关性,FEIR、RBC-ICR与血清细胞因子TNF-α、IL-6水平呈正相关性(P<0.05)。结论产褥期感染产妇红细胞免疫状态较差且血清细胞因子TNF-α、IL-6水平升高,加强产褥期产妇红细胞免疫状态和血清细胞因子水平变化监测,利于产褥感染早期识别、把握感染危险层级、指导临床,阻断病情演变、改善预后。
OBJECTIVE To study the correlation between changes of cytokines and erythrocyte immune status and maternal puerperal infection.METHODS 96 pregnant women with puerperal infection admitted in the hospital from Feb.2015 to Jan.2018 were selected as the observation group and 90 uninfected puerperants during puerperium were included as the control group.WBC counts,procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)levels and erythrocyte immune status at time of puerperal infection,24 hafter treatment,72 hafter treatment and upon completion of the treatment were observed and compared between the two groups.Pearson analysis was conducted to analyze the correlation of puerperal infection and serum cytokines TNF-α,IL-6 and erythrocyte immune status.RESULTS The serum WBC count,PCT,TNF-alpha and IL-6 of patients in the experimental group during puerperal infection were(21.00±4.30)×109/L,(10.60±1.80)ng/ml,(218.00±53.00)pg/ml,(13.20±1.44)pg/ml respectively.These values were(22.50±3.80)×109/L,(12.00±4.50)ng/ml,(276.00±82.00)pg/ml,(14.00±1.68)pg/ml 24 hafter treatment,and(15.50±2.40)×109/L,(7.10±3.30)ng/ml,(148.00±33.00)pg/ml,(11.20±1.34)pg/ml 72 hafter treatment.The levels of serum WBC,PCT,TNF-αand IL-6 at these three time points in the experimental group were significantly higher than those in the control group(P<0.05),but there was no significant difference between the two groups at the end of treatment.During puerperal infection and 24 hafter treatment,FEER of erythrocyte in the experimental group was(23.50±3.10)%and(22.00±3.43)% respectively,significantly lower than those in the control group,FEIR and RBC-ICR were(35.20±3.20)%,(36.00±3.45)% and(11.40±1.52)%,(11.68±1.39)%,significantly higher than those in the control group(P<0.05).The levels of TNF-α,IL-6,serum WBC and PCT were positively correlated(P<0.05).FEER was negatively correlated with FEIR,RBC-ICR,serum cytokines TNF-alpha and IL-6,while FEIR and RBC-ICR were positively correlated with serum cytokines TNF-αand IL-6(P<0.05).CONCLUSIONThe erythrocyte immune status of puerperants during puerperal infection is poor,and the levels of serum cytokines TNF-αand IL-6 are increased.The monitoring of erythrocyte immune status and serum cytokine levels in puerperium should be strengthened,which would help to identify early infection and get to know the risk level of infection,thereby guiding the clinical treatment,blocking the evolution of the disease and improving the prognosis.
作者
韩曼琳
周爱梅
符爱贞
程虹
邢娴静
高梅
HAN Man-lin;ZHOU Ai-mei;FU Ai-zhen;CHENG Hong;XING Xian-jing;GAO Mei(Haikou Maternal and Child Healthcare Hospital,Haikou,Hainan 570203,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第3期443-447,共5页
Chinese Journal of Nosocomiology
关键词
产褥期
感染
细胞因子
红细胞
免疫状态
Puerperium
Infection
Cytokines
Erythrocytes
Immune status
