广西医学

目的分析血清可溶性细胞间黏附分子 1（sICAM-1）和转化生长因子β1（TGF-β1）水平、红细胞免疫复合物花环（RBC-ICR）率、淋巴细胞比例与剖宫产术后发生产褥感染的关系。方法选取108例剖宫产术后发生产褥感染的产妇作为研究组，依据感染程度将其分为轻度组（41例）、中度组（35例）与重度组（32例）。另选取剖宫产术后未发生产褥感染的60例产妇作为对照组。比较研究组与对照组之间，以及轻度组、中度组与重度组之间产前血清sICAM-1和TGF-β1水平、 RBC-ICR率、淋巴细胞比例。采用多因素Logistic回归模型分析影响剖宫产术后发生产褥感染的因素。结果研究组的产前血清sICAM-1和TGF-β1水平、 RBC-ICR率、淋巴细胞比例高于对照组（P＜0.05）。轻度组、中度组、重度组的产前血清sICAM-1和TGF-β1水平、 RBC-ICR率及淋巴细胞比例依次升高（P＜0.05）。多因素Logistic回归分析结果显示，校正混杂因素后，产前血清TGF-β1水平、RBC-ICR率、淋巴细胞比例是剖宫产术后发生产褥感染的独立影响因素（P＜0.05）。结论剖宫产术后发生产褥感染的产妇产前血清sICAM-1和TGF-β1水平、 RBC-ICR率、淋巴细胞比例升高，且四项指标均随着感染程度的加重而升高。产前血清TGF-β1水平、RBC-ICR率、淋巴细胞比例升高的产妇，其剖宫产术后发生产褥感染的风险增加。

ObjectiveTo analyze the relation of serum soluble intercellular adhesion molecule 1 (sICAM-1) and transforming growth factor β1 (TGF-β1) levels, red blood cell immune complex rosette (RBC-ICR) rate, lymphocyte proportion with the occurrence of puerperal infection after Cesarean section. MethodsA total of 108 puerperae suffering from puerperal infection after Cesarean section were selected as study group, and they were divided into mild group (41 cases), moderate group (35 cases), or severe group (32 cases) according to infection degree. Another 60 puerperae who did not suffer from puerperal infection after Cesarean section were selected as control group. Antenatal serum sICAM-1 and TGF-β1 levels, RBC-ICR rate, and lymphocyte proportion were compared between the study group and the control group, and between the mild, moderate, and severe groups. The factors for affecting the occurrence of puerperal infection after Cesarean section were analyzed by the multivariate Logistic regression model. ResultsThe study group exhibited higher antenatal levels of serum sICAM-1 and TGF-β1, a higher antenatal RBC-ICR rate, and a higher antenatal lymphocyte proportion as compared with the control group (P＜0.05). Antenatal serum sICAM-1 and TGF-β1 levels, RBC-ICR rate, and lymphocyte proportion were successively elevated in the mild, moderate, and the severe groups (P＜0.05). The results of multivariate Logistic regression analysis revealed that after adjusting for confounding factors, antenatal serum TGF-β1 level, RBC-ICR rate, and lymphocyte proportion were the independent influencing factors for the occurrence of puerperal infection after Cesarean section (P＜0.05). ConclusionPuerperae suffering from puerperal infection after Cesarean section obtain elevated antenatal serum sICAM-1 and TGF-β1 levels, RBC-ICR rate, and lymphocyte proportion, and the four indices all elevate with the increase of infection degree. Puerperae with the elevations of antenatal serum TGF-β1 level, RBC-ICR rate, and lymphocyte proportion have increased risk for the occurrence of puerperal infection after Cesarean section.