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目的探讨单纯疱疹病毒-Ⅱ型(HSV-Ⅱ)感染孕妇免疫指标水平预测新生儿不良结局的效果。方法选取2012年1月-2013年12月在该院确诊为HSV-Ⅱ感染的孕妇48例为观察组,另选取同期健康孕妇30例为对照组。采用流式细胞仪检测两组T淋巴细胞亚群值。比较两组免疫指标水平和新生儿不良结局的发生情况,并采用ROC曲线分析HSV-Ⅱ感染孕妇免疫指标水平预测新生儿不良结局的效果。结果观察组CD3~+、CD4~+、CD8~+、CD4~+/CD8~+等T淋巴细胞亚群值均低于对照组,差异有统计学意义(P<0.05)。观察组新生儿感染HSV-Ⅱ、死亡、黄疸、窒息、早产、低出生体重等不良结局的发生率和不良结局总发生率均高于对照组,差异有统计学意义(P<0.05)。HSV-Ⅱ感染孕妇CD3~+T淋巴细胞亚群值预测其新生儿不良结局的ROC曲线下面积、灵敏度、特异度、准确性分别为0.758、87.48%、66.25%和91.42%。结论 HSV-Ⅱ感染孕妇免疫指标水平预测其新生儿不良结局效果良好。提高HSV-Ⅱ感染孕妇免疫功能可有效预防新生儿不良结局的发生。
Objective To investigate the effect of herpes simplex virus-Ⅱ (HSV-Ⅱ) immunocompromised pregnant women in predicting adverse outcomes in neonates. Methods Forty eight pregnant women diagnosed as HSV-Ⅱ infection in our hospital from January 2012 to December 2013 were selected as the observation group. Another 30 healthy pregnant women were selected as the control group. T lymphocyte subsets were detected by flow cytometry. The level of immune index and the incidence of adverse neonatal outcomes in both groups were compared. The ROC curve was used to analyze the effect of HSV-Ⅱ on the level of immune markers in pregnant women to predict the adverse outcome of neonates. Results The T lymphocyte subsets of CD3 ~ +, CD4 ~ +, CD8 ~ + and CD4 ~ + / CD8 ~ + in the observation group were lower than those in the control group, with statistical significance (P <0.05). The incidence of neonatal infection with HSV-Ⅱ, death, jaundice, asphyxia, premature birth, low birth weight and other adverse outcomes in the observation group were higher than those in the control group. The difference was statistically significant (P <0.05). The area, sensitivity, specificity and accuracy of CD3 ~ + T lymphocyte subsets in pregnant women with HSV-Ⅱinfection were 0.758, 87.48%, 66.25% and 91.42%, respectively. Conclusions The level of immune markers in pregnant women with HSV-Ⅱ infection has a good effect in predicting the adverse outcome of neonates. Increasing the immune function of HSV-Ⅱ infected pregnant women can effectively prevent the occurrence of adverse outcomes in neonates.