B族链球菌核酸检测在产前筛查中应用.doc

B族链球菌核酸检测在产前筛查中应用 　　[摘要] 目的 探讨B族链球菌核酸检测在产前筛查中的应用价值。 方法 选择2012年7月～2014年6月在我院产科门诊进行常规产检、单胎宫内妊娠、胎儿存活的325例孕妇为研究对象，于孕35～37周取阴道分泌物和肛周分泌物，分别进行细菌培养与实时PCR检测，观察两种检测方法检出效果，比较B族链球菌阳性、阴性对孕产妇妊娠结局及对新生儿结局的影响。 结果 325例孕妇中，B族链球菌细菌培养检出阳性13例（4%），实时PCR检测检出阳性29例（8.92%），特异度为94.9%，灵敏度为100.0%，阳性预测值为44.8%，阴性预测值为100.0%；B族链球菌阳性孕产妇宫内感染（13.79%）、胎膜早破（34.48%）、早产（10.34%）、产后出血（10.34%）均明显高于GBS阴性孕产妇（P0.05）；B族链球菌阳性孕产妇所分娩新生儿肺炎（6.9%）、新生儿败血症（6.9%）、新生儿窘迫（13.79%）明显高于GBS阴性所分娩新生儿（P0.05）。 结论 妊娠晚期B族链球菌携带明显增加了孕产妇宫内感染、胎膜早破、早产、产后出血以及新生儿肺炎、新生儿败血症、新生儿窘迫发生率，B组链球菌核酸检测试验用于产前检查有着重要的意义。 　　[关键词] B族链球菌；实时PCR检测；妊娠结局；新生儿结局 　　[中图分类号] R714.7 [文献标识码] B [文章编号] 2095-0616（2015）24- 81-04 　　[Abstract] Objective To study the application value on the nucleic acid detection of group B streptococcus in prenatal screening. Methods 325 pregnant women with single pregnancy intrauterine pregnancy and surviving fetus， who were carried on routine antenatal examination in obstetrical outpationt department of our hospital from July 2012 to June 2014， were selected as the research objects. To respectively carry on the bacterial culture and real-time PCR detection on the vaginal secretion and perianal secretion at 35-37 gestational weeks， to observe the detection effect between the two detection methods， to compare the effect of group B positive and negative streptococcus on the pregnancy outcome of pregnant women and neonatal outcome. Results Of the 325 pregnant women， the positive detection of bacterial culture in group B streptococcus were 13 cases（4%）， and the positive detection of real-time PCR detection were 29 cases（8.92%）， with the specificity of 94.9%， the sensitivity of 100.0%， the positive predictive value of 44.8%， and the negative predictive value of 100.0%. The intrauterine infection， the premature rupture of membranes， the premature delivery， and the postpartum hemorrhage in pregnant women with positive GBS（13.79%， 34.48%， 10.34%， 10.34%） were obviously higher than which in pregnant women with negative GBS （P0.05）. Conclusion G