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目的探讨胎膜早破对新生儿宫内细菌感染的影响及与脐血IL-6、PCT、CRP、TNF-α相关性,为新生儿宫内细菌感染的诊断提供参考。方法选取2015年6月-12月医院住院分娩的100例胎膜早破产妇,检测是否存在绒毛膜炎及脐血IL-6、PCT、CRP、TNF-α水平,同时观察新生儿宫内细菌感染发生情况。结果产妇发生绒毛膜炎者62例,发生率为62.00%,新生儿发生宫内细菌感染者42例,感染率为42.00%,分娩孕周<37周、胎膜早破时间≥12h、有绒毛膜炎的产妇分娩新生儿宫内细菌感染率分别为73.91%、81.25%、54.84%,高于分娩孕周≥37周、胎膜早破时间<12h、无绒毛膜炎的产妇分娩新生儿的32.47%、23.53%、21.05%(P<0.05);绒毛膜炎产妇分娩新生儿脐血IL-6、PCT、CRP、TNF-α明显高于无绒毛膜炎产妇分娩新生儿(P<0.05),宫内细菌感染新生儿脐血IL-6、PCT、CRP、TNF-α明显高于无宫内细菌感染新生儿(P<0.05);绒毛膜炎产妇分娩新生儿与宫内细菌感染新生儿脐血IL-6、PCT、CRP、TNF-α水平有正相关性(P<0.05)。结论胎膜早破时绒毛膜炎及宫内细菌感染发生率高,绒毛膜炎及宫内细菌感染新生儿脐血IL-6、PCT、CRP、TNF-α显著增高,以上指标可作为诊断新生儿宫内细菌感染的有效指标。
Objective To investigate the effect of premature rupture of membranes on neonatal intrauterine bacterial infection and its correlation with cord blood IL-6, PCT, CRP and TNF-α, and to provide a reference for the diagnosis of neonatal intrauterine bacterial infection. Methods 100 cases of premature rupture of membranes in hospital from June 2015 to December 2015 were selected to detect the presence of chorioamnionitis and levels of IL-6, PCT, CRP and TNF-α in cord blood, The incidence of infection. Results 62 cases of chorioamnion occurred, the incidence was 62.00%, neonatal intrauterine bacterial infection in 42 cases, the infection rate was 42.00%, gestational age <37 weeks, premature rupture of membranes ≥ 12h, with villi The rates of intrauterine bacterial infection of maternal neonates with membranitis were 73.91%, 81.25% and 54.84%, respectively, which were higher than those of gestational weeks ≥37 weeks, and those with premature rupture of membranes <12 hours. 32.47%, 23.53% and 21.05%, respectively (P <0.05). The levels of IL-6, PCT, CRP and TNF-α in newborns with chorioamitis were significantly higher than those without chorioamnion (P0.05) (P <0.05). The levels of IL-6, PCT, CRP and TNF-α in newborn infants with intrauterine bacterial infection were significantly higher than those without intrauterine bacterial infection (P <0.05). Neonates with intrauterine infection and chorioamnion The levels of IL-6, PCT, CRP and TNF-α in cord blood were positively correlated (P <0.05). Conclusion The incidence of choriomyelitis and intrauterine bacterial infection in premature rupture of membranes is high. The levels of IL-6, PCT, CRP and TNF-α in umbilical cord blood of chorioamnionitis and intrauterine bacterial infection are significantly higher Effective indicator of intrauterine bacterial infection.