Risk factors of the puerperal infection and the predictive value of total antioxidant capacity,interferon gamma and α1 a-cidic glycoprotein
Objective:To analyze the risk factors of the puerperal infection,and to study the predictive value of the lev-els of total antioxidant capacity(TAC),interferon gamma(IFN-γ)and α1 acidic glycoprotein(α1-AG)of puerperas for their puerperal infection.Methods:The clinical data of 250 puerperas from June 2020 to January 2023 were selected in this study retrospectively.According to the incidence of puerperal infection or not,these puerperas were divided into the study group(31 puerperas with puerperal infection)and control group(219 puerperas without puerperal infection).The clinical data of the puerperas in the two groups were collected,and the risk factors of the puerperal infection of the puerperas in the two groups were analyzed.The serum TAC,IFN-γ and α1-AG levels of the puerperas in the two groups were detected,and the predictive value of which of the puerperas for predicting their puerperal infection was an-alyzed by subject working characteristic curve.Results:Univariate analysis showed that there were no significant differences in the age,the gestational weeks,the parity and the endocrine diseases occurrence of the puerperas between the two groups(P＞0.05).There were signifficnt differences in the labor duration,the incidences of gynecological in-flammation,gestational hypertension disease,gestational diabetes mellitus,and postpartum hemorrhage,the resi-dence,the delivery mode,the premature rupture of membranes,and the time of the resting in bed of the puerperas be-tween the two groups(P＜0.05).The levels of serum IFN-y(150.05±36.25 pg/ml)and α1-AG(156.35±40.91 mg/dl)of the puerperas in the study group were significantly higher than those(134.71±30.56 pg/ml and 116.25±38.36 mg/dl)of the puerperas in the control group.The TAC level(8.20±1.50 kU/ml)of the puerperas in the study group was significantly lower than that(10.83±2.45 kU/ml)of the puerperas in the control group(all P＜0.05).There were no significant differences in the white blood cell count and the C-reactive protein and procalcitonin levels of the pu-erperas between the two groups(P＞0.05).The white blood cell count and the C-reactive protein and procalcitonin lev-els of the puerperas in the two group after delivery had increased significantly,and which of the puerperas in the study group were significantly higher than of the puerperas in the control group(P＜0.05).Multivariate unconditional logis-tic analysis showed that the long time of labor,the gynecological inflammation,the hypertensive disorders of pregnan-cy,the gestational diabetes mellitus,the postpartum hemorrhage,the rural residence,the cesarean section,the pre-mature rupture of membranes,the time of resting in bed ≥3 days,the decreased TAC level and the increased IFN-γand α1-AG levels of the puerperas were the independent risk factors for their puerperal infection(P＜0.05).ROC re-sults showed that the area under the curve(AUC),the sensitivity,the specificity and the cut-off value of the serum TAC level of the puerperas for predicting their puerperal infection were 0.808,76.3％,79.5 and 9.56 kU/ml,respec-tively.The AUC,the sensitivity,the specificity and the cut-off value of the serum IFN-γlevel of the puerperas for pre-dicting their puerperal infection were 0.651,61.5％,69.4％and 141.24 pg/ml,respectively.The AUC,the sensitivi-ty,the specificity and the cut-off value of the serumα1-AG level of the puerperas for predicting their puerperal infection were 0.753,73.4％,70.8％and 130.35 mg/dl,respectively.Conclusion:The long time of labor,the gynecological in-flammation,the hypertensive disorders of pregnancy,the gestational diabetes mellitus,the postpartum hemorrhage,the rural residence,the cesarean section,the premature rupture of membranes and the long time of resting in bed of the puerperas are all the independent risk factors for their puerperal infection.The expressions of the serum TAC,IFN-γ and α1-AG of the puerperas with puerperal infection are abnormal,and which have certain predicting values for the puerperal infection of the puerperas.
Puerperal infectionTotal antioxidant capacityInterferon gammaα1 acid glycoproteinRisk factorsPredictive value
万方数据
维普
