亚临床绒毛膜羊膜炎孕妇血清粒细胞-巨噬细胞集落刺激因子水平及其临床意义  

Serum GM-CSF levels in pregnant women with subclinical chorioamnionitis and its clinical significance

作　　者：潘雪君[1] 王娇连 陈迎迎[1] 李阳 周凌娟[1] PAN Xuejun;WANG Jiaolian;CHEN Yingying(Department of Obstetrics,Yuhang District Maternal and Child Health Hospital,Hangzhou 311100,China)

机构地区：[1]杭州市余杭区妇幼保健院产科,311100

出　　处：《浙江医学》2020年第4期374-378,共5页Zhejiang Medical Journal

摘　　要：目的探讨胎膜早破亚临床绒毛膜羊膜炎孕妇血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平及其临床意义。方法选择产科胎膜早破亚临床绒毛膜羊膜炎孕妇90例作为观察组、胎膜早破无亚临床绒毛膜羊膜炎孕妇90例作为对照组。测量血清GM-CSF、C反应蛋白(CRP)、降钙素原(PCT)水平。结果观察组血清GM-CSF、CRP、PCT水平均高于对照组(均P<0.05)。根据病理学炎症严重程度分级,将亚临床绒毛膜羊膜炎患者分为轻度组、中度组和重度组,与轻度组比较,中度和重度组亚临床绒毛膜羊膜炎血清GM-CSF、CRP、PCT水平均升高(均P<0.05);与中度组比较,重度组亚临床绒毛膜羊膜炎血清GM-CSF、CRP、PCT水平均升高(均P<0.05)。亚临床绒毛膜羊膜炎血清GM-CSF与CRP、PCT呈正相关(P<0.05)。分别以血清GM-CSF、CRP、PCT及三项联合诊断亚临床绒毛膜羊膜炎绘制ROC曲线,结果显示:血清GM-CSF、CRP、PCT及3项联合检测诊断亚临床绒毛膜羊膜炎的ROC曲线下面积、95%CI、P值分别为0.793、0.789~0.797、0.000;0.734、0.730~0.738、0.000;0.765、0.761~0.769、0.000;0.883、0.880~0.885、0.000。结论亚临床绒毛膜羊膜炎孕妇血清GM-CSF水平升高,血清GM-CSF可用于评估炎症严重程度,GM-CSF联合CRP、PCT检测对亚临床绒毛膜羊膜炎有诊断价值。Objective To investigate the expression of serum granulocyte-macrophage colony-stimulating factor(GM-CSF)levels and its clinical significance in premature rupture of membranes women with subclinical chorioamnionitis.Methods Ninety patients with premature rupture of membranes and subclinical chorioamnionitis(study group)and 90 pregnant women with premature rupture of membranes without subclinical chorioamnionitis(control group)admitted in Department of Obstetrics,Yuhang District Maternal and Child Health Hospital were enrolled in the study.The serum GM-CSF,C-reactive protein(CRP),procalcitonin(PCT)levels were measured.Results The serum levels of GM-CSF,CRP and PCT in the study group were significantly higher than those in the control group(P<0.05).Accorded to the severity of pathological inflammation,patients with subclinical chorioamnionitis were divided into mild group,moderate group and severe group.Compared with the mild group,the serum levels of GM-CSF,CRP and PCT in the moderate and severe groups were significantly increased(P<0.05);while the levels in severe group were significantly higher than those in moderate group(P<0.05).The serum GM-CSF in patients with subclinical chorioamnionitis was positively correlated with CRP and PCT(P<0.05).ROC curves showed that the area under the ROC curve(AUC),95%CI,P values of GM-CSF,CRP,PCT and three combined detection in the diagnosis of subclinical chorioamnionitis were 0.793,0.789~0.797,0.000;0.734,0.730~0.738,0.000;0.765,0.761~0.769,0.000;and 0.883,0.880~0.885,0.000.Conclusion The serum GM-CSF level is elevated in pregnant women with subclinical chorioamnionitis.The serum GM-CSF can be used to assess the severity of inflammation and it can improve the diagnostic value of CRP and PCT for subclinical chorioamnionitis.

关 键 词：胎膜早破 粒细胞-巨噬细胞集落刺激因子 C反应蛋白 降钙素原 

分 类 号：R714.433[医药卫生—妇产科学]