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目的采用免疫层析法快速检测临产急诊入院孕妇生殖道B族链球菌(GBS)带菌情况以及追踪母婴结局,研究其应用于孕晚期GBS筛查的临床价值。方法免疫层析法筛查出GBS阳性54例为研究组,GBS阴性414例为对照组。通过与微生物鉴定培养法的结果进行对比,研究免疫层析法的灵敏度、特异性,并观察孕妇GBS感染阳性者与阴性者的妊娠结局与新生儿预后。结果免疫层析法检测GBS感染阳性率为11.54%,高于培养法的6.20%(P<0.05),其灵敏度为100.00%、特异性为94.66%。GBS阳性组胎膜早破、宫内感染、新生儿窒息以及新生儿感染发生率分别为29.63%、14.81%、7.41%、18.52%,明显高于GBS阴性组(P<0.05),而早产、胎儿窘迫、产褥感染以及剖宫产发生率两组无明显差异(P>0.05)。结论免疫层析法可成为检测孕晚期GBS感染的一种快速准确的方法,且简便、灵敏,尤其适合在临产前的快速诊断,为及时预防用药提供时机。
OBJECTIVE To rapidly detect the carriage of Streptococcus group B Streptococcus (GBS) in pregnant women admitted to emergency labor and to track the maternal and infant outcome by immunochromatography, and to investigate the clinical value of GBS screening in the third trimester of pregnancy. Methods Fifty-four GBS positive samples were screened out by immunochromatography and 414 negative GBS samples were used as control group. By comparing with the results of microbial identification culture method, the sensitivity and specificity of immunochromatography were studied, and the pregnancy outcome and neonatal prognosis of pregnant women with positive and negative GBS infection were observed. Results The positive rate of GBS infection detected by immunochromatography was 11.54%, higher than that of culture method (6.20%, P <0.05). The sensitivity and specificity were 100.00% and 94.66% respectively. The incidence of premature rupture of membranes, intrauterine infection, neonatal asphyxia and neonatal infection in GBS positive group were 29.63%, 14.81%, 7.41% and 18.52% respectively, which were significantly higher than those in GBS negative group (P <0.05) Fetal distress, puerperal infection and the incidence of cesarean section there was no significant difference between the two groups (P> 0.05). Conclusion Immunochromatography can be a rapid and accurate method for the detection of GBS infection in the third trimester of pregnancy. It is simple and sensitive, especially suitable for rapid diagnosis before labor and provides the opportunity for timely prevention of drug use.