血清可溶性人白细胞抗原G测定在诊断亚临床绒毛膜羊膜炎中的意义  

Significance of detection of maternal serum sHLA-G in diagnosis of histological chorioamnionitis

作　　者：赵明瑜[1] 张璐[1] 徐志敏[1] 鹿理友 张蔚[1] 

机构地区：[1]烟台市烟台山医院,山东烟台264001

出　　处：《医药论坛杂志》2013年第1期7-9,共3页Journal of Medical Forum

摘　　要：目的探讨孕妇血清可溶性人白细胞抗原G(sHLA-G)测定在诊断妊娠合并亚临床绒毛膜羊膜炎中的意义。方法选取早产及胎膜早破孕产妇115例及正常足月分娩孕产妇40例,通过运用双抗体夹心酶联免疫吸附(ELISA)法检测上述研究对象血清中sHLA-G的水平,同时用散射比浊法测定其中C反应蛋白(CRP)含量,最后对所有产后胎膜进行病理检查,判断有无绒毛膜羊膜炎。结果①通过对产后胎膜组织进行病理检查,共检测出绒毛膜羊膜炎患者70例,作为研究组,另外85例无绒毛膜羊膜炎患者作为对照组;②研究组血清中sHLA-G的水平平均为(46.52±13.75)U/ml,显著高于对照组(28.48±10.76U/ml),差异有统计学意义(P<0.001);③研究组血清中CRP的水平平均为(13.39±12.48)mg/L,显著高于对照组(5.49±5.45mg/L),差异有统计学意义(P<0.001);④用ROC曲线分析:血清sHLA-G检测绒毛膜羊膜炎的最佳临界值为36.09U/ml,诊断敏感性77.1%,特异性75.3%,曲线下面积0.847,明显优于CRP(敏感性68.6%,特异性68.2%,曲线下面积0.739,最佳临界值为7.5mg/L)。结论发生绒毛膜羊膜炎时,母血中sHLA-G的水平升高,与CRP相比,有更高的敏感性和特异性,提示sHLA-G是诊断亚临床绒毛膜羊膜炎的较理想的血清学指标。Objective To evaluate the value of maternal serum sHLA - G for detecting histological chorioamninitis. Methods Totally 115 pregnant women with premature rupture of membranes or preterm delivery and 40 cases of normal pregnancy were enrolled in this study. Serum sHLA - G levels were measured by enzyme - linked immunosorbent assay （ELISA）. CRP were detected simultaneously, and fetal membranes were collected to conduct pathological xamination. Results Maternal serum sH1A - G levels were significantly higher in women with ehorioamnionitis than those without （P 〈 0. 05）. The sensitivity, specificity and area under ROC curve of serum sHLA -G（ cutoff 36.09U/ml） and CRP（ cutoff 7.5 mg/L） for diagnosing ehorioamnionitis were 77. 1% ,75.3% ,0. 847and 68.6. 0% ,68. 2% ,0. 739, respectively. Conclusions Maternal serum levels of sHLA - G are elevated in histologie chorioamnionitis. We propose that sHLA - G is a more useful marker for early detection of histologic chorioamnionitis than CRP.

关 键 词：可溶性人白细胞抗原G 绒毛膜羊膜炎 CRP 

分 类 号：R446.6[医药卫生—诊断学]