胎膜早破孕妇血清hs-CRP IL-6 TNF-α及PCT水平及临床意义  

Levels and Clinical Significance of Serum Hs-CRP IL-6 TNF-α and PCT in Pregnant Women with Premature Rupture of Membranes

作　　者：黄慧[1] 陈俪媛 王瀚[1] HUANG Hui;CHEN Liyuan;WANG Han(Wuhan First Hospital,Hubei Wuhan 430000,China)

机构地区：[1]湖北省武汉市第一医院产科,湖北武汉430000

出　　处：《河北医学》2020年第6期998-1002,共5页Hebei Medicine

基　　金：湖北省卫生和计划生育委员会科研项目,(编号:WX17C06)。

摘　　要：目的:分析胎膜早破孕妇血清hs-CRP、IL-6、TNF-α及PCT水平及临床意义。方法:选择2018年1月至2019年6月我院妇产科收治的胎膜早破合并宫内感染的38例孕妇为感染组,胎膜早破未合并宫内感染的54例孕妇为未感染组,并以60例健康孕妇为对照组。采集三组孕妇晨间空腹肘静脉血,检测血清hs-CRP、IL-6、TNF-α及PCT水平。结果:感染组孕妇血清hs-CRP、IL-6、TNF-α、PCT水平>未感染组>对照组(P<0.05);感染组足月与未足月孕妇血清hs-CRP、IL-6、TNF-α、PCT水平>未感染组,感染组和未感染组未足月孕妇血清hs-CRP、IL-6、TNF-α及PCT水平>同组足月孕妇(P<0.05);感染组重度感染孕妇血清hs-CRP、IL-6、TNF-α、PCT水平>中度>轻度(P<0.05);ROC曲线分析,血清hs-CRP、IL-6、TNF-α、PCT水平预测胎膜早破孕妇宫内感染均具有较高诊断价值,而其联合预测的AUC值最大,敏感度、特异度达90.6%、92.7%。结论:联合检测血清hs-CRP、IL-6、TNF-α、PCT水平对胎膜早破孕妇早期宫内感染具有积极的预测价值。Objective:To explore levels and the clinical significance of serum hs-CRP,IL-6,TNF-αand PCT in pregnant women with premature rupture of membranes(PROM).Methods:During the period from January 2018 to June 2019,38 pregnant women with PROM and intrauterine infection who were admitted to obstetrics and gynecology department of the hospital were enrolled as infection group.54 pregnant women with PROM and without intrauterine infection were enrolled as non-infection group.60 healthy pregnant women who underwent production inspection and delivery during the same period in the hospital were enrolled as control group.The fasting elbow venous blood in the morning of the three groups was collected.The levels of serum hs-CRP,IL-6,TNF-αand PCT were detected by enzyme-linked immunosorbent assay.Results:The levels of serum hs-CRP,IL-6,TNF-αand PCT were the highest in infection group,followed by non-infection group and control group(P<0.05).The levels of serum hs-CRP,IL-6,TNF-αand PCT of full-term and incomplete pregnant women in infection group were higher than those in non-infection group.The levels of serum hs-CRP,IL-6,TNF-αand PCT of incomplete pregnant women were higher than those of full-term pregnant women in infection group and non-infection group(P<0.05).In infection group,levels of serum hs-CRP,IL-6,TNF-αand PCT were the highest in pregnant women with severe infection,followed by moderate infection and mild infection(P<0.05).ROC curve analysis showed that serum hs-CRP,IL-6,TNF-αand PCT levels were of relatively higher diagnostic value for predicting intrauterine infection of PROM pregnant women.AUC of their combined prediction was the largest.The sensitivity and specificity were 90.6%and 92.7%,respectively.Conclusion:The combined detection with serum hs-CRP,IL-6,TNF-αand PCT levels is of positive predictive value for early intrauterine infection in pregnant women with PROM.

关 键 词：胎膜早破 宫内感染 超敏C-反应蛋白 白细胞介素-6 肿瘤坏死因子-α 降钙素原 

分 类 号：R714.433[医药卫生—妇产科学]