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目的:探讨早产与生殖道感染的相关性及生殖道感染主要致病菌。方法:前瞻性分析2009年1月至2010年12月在我院产前检查及分娩的病例共1 832例,排除内外科合并症、产科原因所致流产、早产及生殖道器质性病变所致早产等情况外,将参与研究者按照初次产前检查是否存在生殖道感染,分为研究组和对照组,对于研究组成员,随机分为接受抗生素治疗(A组)、未接受抗生素治疗(B组)(所有抗生素治疗均根据药敏结果进行)。结果:发生流产的机率:生殖道感染组(B组)发生率为3.2%,与A组及对照组均有统计学差异,A组(2.2%)与对照组(2.0%)之间流产率差异无统计学意义。妊娠28～31~(+6)周早产发生率B组(13.6%)较A组(6.1%)及对照组(1.6%)均高,差异有统计学意义(P<0.05),妊娠32～33~(+6)周早产发生率与妊娠28～31~(+6)周相似,妊娠34～35~(+6)周早产发生率3组均无明显统计学差异。同时A组在28～31~(+6)及32～33~(+6)周发生的早产较对照组明显增高,且差异有统计学意义(P<0.05)。主要病原菌依次为:无乳链球菌(42.2%)、大肠埃希氏菌(33.7%)、表皮葡萄球菌(10.8%)、其他细菌如金黄色葡萄球菌、大肠杆菌等(13.3%),此外支原体阳性率(62%),多伴发其他生殖道细菌感染。结论:早产与生殖道感染存在明显的相关性,尤其是较早期早产的发生,通过针对病原茵的抗生素治疗可以有效降低早产的发生率。
Objective: To explore the correlation between preterm birth and genital tract infection and the main pathogens of reproductive tract infections. Methods: A total of 1 832 cases of prenatal examination and childbirth in our hospital from January 2009 to December 2010 were prospectively analyzed. Excluding the complications of internal medicine and surgery, the abortion, premature birth and reproductive tract organic diseases caused by obstetric reasons Induced premature delivery and other conditions, will participate in the researchers in accordance with the first prenatal check for the presence of genital tract infection, divided into study group and control group, the study group members were randomly divided into antibiotic treatment (group A), did not receive antibiotics Group B) (All antibiotic treatments are based on susceptibility results). Results: The incidence of miscarriage: The incidence of genital tract infection (group B) was 3.2%, which was significantly different from that of group A and control group. The miscarriage rate between group A (2.2%) and control group (2.0%) The difference was not statistically significant. The incidence of preterm birth was significantly higher in group B (13.6%) than that in group A (6.1%) and control group (1.6%) during the 28-31 (+6) weeks of gestation, with a significant difference (P < The incidence of preterm birth in 33 ~ (+6) weeks was similar to that in 28 ~ 31 ~ (+6) weeks of gestation, and there was no significant difference in the incidence of preterm birth in 34 ~ 35 ~ (+6) weeks gestation. At the same time, the preterm birth in group A between 28 ~ 31 ~ (+6) and 32 ~ 33 ~ (+6) weeks was significantly higher than that in control group, and the difference was statistically significant (P <0.05). The main pathogens were: Streptococcus agalactiae (42.2%), Escherichia coli (33.7%), Staphylococcus epidermidis (10.8%), other bacteria such as Staphylococcus aureus, Escherichia coli, etc. (13.3% Positive rate (62%), often accompanied by other genital tract bacterial infections. Conclusions: There is a clear correlation between preterm birth and genital tract infection, especially in the early stage of prematurity. The antibiotic treatment for the pathogen can effectively reduce the incidence of preterm birth.