摘要
目的:探讨降钙素原(procalcitonin,PCT)联合白细胞介素-6(interleukin-6,IL-6)在早期诊断胎膜早破合并绒毛膜羊膜炎的应用。方法:选取2016年6-12月本院收治的胎膜早破孕妇100例为观察组,另选取同期收治的足月正常分娩孕妇50例为对照组。检测两组孕妇PCT、IL-6水平及阳性表达率情况。并于分娩后对所有孕妇取胎盘胎膜组织行病理检查,根据病理检查结果,将胎膜早破孕妇分为有绒毛膜羊膜炎组(n=46)和无绒毛膜羊膜炎组(n=54),比较其血清PCT、IL-6水平及阳性表达率情况;并采用ROC曲线评估PCT联合IL-6对胎膜早破合并绒毛膜羊膜炎的早期诊断作用。结果:观察组PCT检测水平及阳性表达率均明显高于对照组,观察组IL-6检测水平及阳性表达率均明显高于对照组(P<0.05);有绒毛膜羊膜炎组PCT检测水平及阳性表达率均明显高于无绒毛膜羊膜炎组(P<0.05);有绒毛膜羊膜炎组IL-6检测水平及阳性表达率均明显高于无绒毛膜羊膜炎组(P<0.05);有绒毛膜羊膜炎组PCT、IL-6均为阳性率69.57%(32/46)明显高于无绒毛膜羊膜炎组的18.51%(10/54)(P<0.05);ROC曲线分析结果显示,PCT早期诊断胎膜早破合并绒毛膜羊膜炎的敏感度为84.78%(39/46)、特异度为88.89%(48/54)、准确性为87.00%(87/100)、阳性预测值为86.67%(39/45)、阴性预测值87.27%(48/55);IL-6早期诊断胎膜早破合并绒毛膜羊膜炎的敏感度为86.96%(40/46)、特异度为90.74%(49/54)、准确性为89.00%(89/100)、阳性预测值为88.89%(40/45)、阴性预测值89.09%(49/55);PCT+IL-6早期诊断胎膜早破合并绒毛膜羊膜炎的敏感度为89.13%(41/46)、特异度为92.59%(50/54)、准确性为91.00%(91/100)、阳性预测值为91.11%(41/45)、阴性预测值90.91%(50/55)。结论:胎膜早破合并绒毛膜羊膜炎孕妇PCT、IL-6水平均升高,PCT联合IL-6可早期诊断胎膜早破合并绒毛膜羊膜炎,对临床早期治疗具有重要意义。
Objective： To investigate the application of procaleitonin （ PCT ） combined with interleukin-6 （ IL-6 ） in the early diagnosis of premature rupture of membranes with ehorioamnionitis.Method： A total of 100 cases of premature rupture of membranes in our hospital from June 2016 to December 2016 were selected as the observation group.Another 50 cases of full-term normal delivery pregnant women were selected as the control group.The levels of serum PCT, IL-6 and positive expression rate of two groups were detected.Pathological examination of placenta and fetal membranes was carried out after delivery.According to the results of pathological examination, premature rupture of fetal membranes were divided into non-chorioamnionitis group （ n=54 ） and chorioamnionitis group （ n=46 ） .The serum levels of PCT and IL-6, and the positive rate of IL-6 were compared. ROC curve was used to evaluate the early diagnostic value of PCT combined with amniotic membrane in patients with premature rupture of membranes and chorioamnionitis.Result： The levels of PCT and positive expression rate in the observation group were significantly higher than those in the control group, while the level of IL-6 and positive expression rate in the observation group were significantly higher than those in the control group （ P〈0.05 ）. The level of PCT and positive expression rate of in chorioamnionitis group were significantly higher than those in non-chorioamnionitis group （P〈0.05） .The level of IL-6 and positive expression rate of chorioamnionitis group were significantly higher than those in non-chorioamnionitis group （ P〈0.05 ） .PCT and IL-6 positive rate of chorioamnionitis group were significantly higher than that of non-chorioamnionitis group （ P〈0.05 ） .ROC curve analysis showed that PCT in the early diagnosis of premature rupture of membranes with chorioamnionitis, sensitivity was 84.75% （ 39/46 ）, specificity was 88.89% （48/54）, accuracy was 87% （ 87/100 ）, positive predictive value was 86.67% （ 39/45 ）, and negative predictive value was 87.27% （ 48/55 ） .IL-6 in the early diagnosis of premature rupture of membranes with chorioamnionitis, sensitivity was 86.96% （40/46） and specificity was 90.74% （49/54）, accuracy was 89.00% （ 89/100 ）, positive predictive value was 88.89% （ 40/45 ）, and negative predictive value was 89.09% （ 49/55 ） .PCT＋IL-6 in the early diagnosis of premature rupture of membranes with chorioamnionitis, sensitivity was 89.13% （ 41/46 ） and specificity was 92.59% （ 50/54 ）, accuracy was 91.00% （91/100）, positive predictive value was 91.11% （41/45）, and negative predictive value was 90.91% （ 50/55 ） .Conclusion： PCT and IL-6 of pregnant women with premature rupture of membranes with chorioamnionitis are increased, PCT combined with IL-6 can early diagnose premature rupture of membranes with chorioamnionitis, it is important for early clinical treatment.
出处
《中国医学创新》
CAS
2017年第17期10-14,共5页
Medical Innovation of China
基金
中山市科技计划项目(2015B1174)
