Risk factors for puerperal infections in cesarean section puerpera and levels of Th17/Treg cells
OBJECTIVE To analyze the risk factors for puerperal infection in the puerpera and observe the change of levels of Th17/Treg cells so as to provide bases for prevention of puerperal infection.METHODS A total of 780 puerpera who underwent cesarean section in the Second Affiliated Hospital of Fujian Medical University from Jan 2019 to Jan 2023 were recruited as the research subjects and were divided into the infection group with 34 cases and the non-infection group with 746 cases according to the status of postoperative puerperal infection.The distri-bution of pathogens was observed,univariate analysis and multivariate logistic regression analysis were performed for the risk factor for the infection.The levels of cytokines procalcitonin(PCT),C-reactive protein(CRP)and white blood cell(WBC)as well as the percentages of type 17 helper T(Th17)and regulatory T(Treg)cells were detected for the two groups of subjects.RESULTS Of the 780 cesarean section puerpera,34 had puerperal infec-tion,with the infection rate 4.36％.Totally 52 strains of pathogens were isolated,37(71.15％)of which were gram-negative bacteria,and 15(28.85％)were gram-positive bacteria.The result of multivariate logistic regres-sion analysis showed that premature rupture of membranes,postpartum hemorrhage and prenatal albumin less than 35g/L were the risk factors for the puerperal infection in the cesarean section puerpera(OR=2.232,2.474,2.186,all P＜0.001).The PCT,CRP and WBC levels,percentage of Th17 and Th17/Treg of the infection group were higher than those of the non-infection group,while the percentage of Treg of the infection group was lower than that of the non-infection group(P＜0.05).CONCLUSION The incidence of puerperal infection is high among the cesarean section puerpera.The gram-negative bacteria are dominant among the pathogens causing the infec-tion.The risk factors include the premature rupture of membranes,postpartum hemorrhage and prenatal albumin less than 35 g/L.The imbalance of Th17/Treg has remarkable effect on the puerperal infection of the cesarean section puerpera.
Cesarean sectionPuerperal infectionPathogenRisk factorType 17 helper cellRegulatory T cellProcalcitoninC-reactive protein
NETL
NSTL
万方数据
维普
