血清LBP和β-hCG及分泌物GBS预测胎膜早破合并羊膜腔感染的临床价值  

Clinical value of serum LBP,β-hCG and secretion GBS test in diagnosis of premature rupture of membranes complicated with amniotic cavity infection

作　　者：周俏苗 郑林媚[2] 肖美芳 陈秋霞 施蕾[2] ZHOU Qiao-miao;ZHENG Lin-mei;XIAO Mei-fang;CHEN Qiu-xia;SHI Lei(Hainan Women and Children Medical Center,Haikou,Hainan 570206,China)

机构地区：[1]海南省妇女儿童医学中心妇产科,海南海口570206 [2]海南省人民医院妇产科,海南海口570311 [3]海南省妇女儿童医学中心检验科,海南海口570206

出　　处：《中华医院感染学杂志》2020年第18期2816-2820,共5页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金面上项目(819MS119)。

摘　　要：目的探讨血清脂多糖结合蛋白(LBP)和β-人绒毛膜促性腺激素(β-hCG)水平及分泌物B族链球菌(GBS)检测对胎膜早破(PROM)合并羊膜腔感染(IAC)的诊断价值。方法选取2017年2月-2019年7月海南省妇女儿童医学中心收治的164例PROM患者,根据是否发生IAC分为合并IAC组(60例)、PROM组(104例),并选取同期88名无PROM及IAC产妇作为对照组,比较三组研究对象临床资料,单因素及多因素Logistic回归分析PROM合并IAC的影响因素,采用受试者工作特征曲线(ROC)分析各指标对PROM合并IAC的诊断价值。比较LBP、β-hCG高危与低危患者、分泌物GBS阳性与阴性患者PROM合并IAC的发生率。结果破膜至分娩时间、破膜后行阴道检查次数、阴道炎、高LBP、高β-hCG及分泌物GBS阳性均为PROM合并IAC发生的影响因素(P<0.05);LBP诊断PROM合并IAC的AUC为0.679,优于β-hCG;LBP、β-hCG高危患者PROM合并IAC发生率均高于低危患者,分泌物GBS阳性患者PROM合并IAC的发生率较阴性患者高(P<0.05)。结论PROM合并IAC患者血清LBP、β-hCG高表达,分泌物GBS阳性率较高,三者联合检测,对临床干预PROM合并IAC的发生提供量化参考。OBJECTIVE To explore the value of serum lipopolysaccharide binding protein(LBP)andβ-human chorionic gonadotropin(β-hCG)and secretion group B Streptococcus(GBS)test in diagnosis of premature rupture of membranes(PROM)complicated with infection of amniotic cavity(IAC).METHODS A total of 164 patients with PROM who were treated in Hainan Women and Children Medical Center from Feb 2017 to Jul 2019 were enrolled in the study and divided into the complicated IAC group with 60 cases and the PROM group with 104 cases according to the status of IAC,meanwhile,88 pregnant women without PROM and IAC were chosen as the control group.The clinical data were compared among the three groups of study objects,univariate analysis and multivariate logistic regression analysis were performed for influencing factors for PROM complicated with IAC,the value of the indexes in diagnosis of PROM complicated with IAC was analyzed by means of receiver operating characteristic(ROC)curve.The incidence of IAC was compared between the LBP,β-hCG high risk and low-risk patients as well as between the GBS-positive patients and the GBS-negative patients.RESULTS The interval between rupture of membranes to delivery,number of times of vaginal examinations after rupture,vaginitis,high LBP level,highβ-hCG level and positive GBS were the influencing factors for the IAC in the PROM patients(P<0.05).The AUC of the LBP was 0.679 in the diagnosis of the PROM complicated with IAC,better than that ofβ-hCG.The incidence of IAC was higher in the high-risk LBP,β-hCG PROM patients than in the low-risk LBP,β-hCG PROM patients;the incidence of IAC was significantly higher in the GBS-positive patients than in the GBS-negative patients(P<0.05).CONCLUSION The levels of serum LBP andβ-hCG are high in the PROM patients complicated with IAC,and the positive rate of GBS in secretions is high.The joint detection of the three indexes may provide quantitative reference for the clinical intervention to the PROM complicated with IAC.

关 键 词：脂多糖结合蛋白 Β-人绒毛膜促性腺激素 分泌物B族链球菌 胎膜早破 羊膜腔感染 

分 类 号：R722.13[医药卫生—儿科]