【摘要】 目的 研究产妇产褥感染血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平变化及危险因素。方法 选取2019年5月至2021年12月南阳市中心医院分娩产妇628例，分析产褥感染相关危险因素及感染组IL-6、TNF-α、IFN-γ水平变化。结果26例，感染率4.14%。感染组感染时（T1）、治疗第1d(T2)、3d(T3)、治疗结束时（T4）,IL-6、TNF-α水平先升高、后下降，IFN-γ先下降、后升高（P<0.05）；但T1、T2、T3时，感染组IL-6、TNF-α水平始终高于未感染组，IFN-γ水平始终低于未感染组，差异有统计学意义（P<0.05）。感染组妊娠合并症、剖宫产、胎膜早破、产程≥12 h、侵入性操作、血红蛋白<120 g/L、卧床时间≥3 d构成比均高于未感染组（P<0.05）。Logistic多因素分析显示妊娠合并症、剖宫产、胎膜早破、产程、侵入性操作、血红蛋白、卧床时间因素是产妇产褥感染危险因素（P<0.05）。结论 积极控制危险因素，利于降低产妇产褥期感染率；且加强产妇IL-6、TNF-α、IFN-γ水平动态监测，有助于早发现、早干预，降低产褥感染危害、避免炎症反应扩大。更多还原

【Abstract】 Objective To study the changes of serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)levels and risk factors in maternal puerperal infection. Methods A total of628 puerperae in Nanyang Central Hospital from May 2019 to December 2021 were selected,and the risk factors related to puerperal infection and the changes of IL-6,TNF-αand IFN-γ levels in the infection group were retrospectively analyzed. Results 26 of 628 patients were infected,and the infection rate was 4.14%. In the infection group,the levels of IL-6 and TNF-αincreased first and then decreased,and IFN-γdecreased first and then increased at the time of infection(T1),the first day(T2),3 days(T3),and the end of treatment(T4).However,at T1,T2,and T3,the levels of IL-6 and TNF-αin the infected group were always higher than those in the uninfected group,and the level of IFN-γ was always lower than that in the uninfected group,and the differences were statistically significant(P<0.05). Pregnancy complications,cesarean section,premature rupture of membranes,labor duration≥12 hours,invasive operation,hemoglobin <120 g/L,and bed rest≥3 days in the infection group were higher than those in the uninfected group(P<0.05). Logistic multivariate analysis regression model showed that pregnancy complications,cesarean section,premature rupture of membranes,labor process,invasive operation,hemoglobin,and bed rest were risk factors for puerperal infection. Conclusion Active control of risk factors will help reduce the puerperium infection rate of puerperium;and strengthen the dynamic monitoring of maternal IL-6,TNF-α,IFN-γ levels. It is helpful for early detection and early intervention,reducing the harm of puerperal infection and avoiding the expansion of inflammatory response.更多还原