未足月胎膜早破孕妇发生组织学绒毛膜羊膜炎的危险因素分析  

Analysis of risk factors for histological chorioamnionitis in pregnant women with preterm premature rupture of membranes

作　　者：徐惠芳[1] 楼文文[2] 宫剑[2] 熊文栋[1] 倪娟娟[1] XU Hui-fang;LOU Wen-wen;GONG Jian;XIONG Wen-dong;NI Juan-juan(Department of Gynecology,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China;不详)

机构地区：[1]温州医科大学附属第二医院妇产科,浙江温州325027 [2]温州医科大学附属第二医院检验医学学科,浙江温州325027

出　　处：《中国卫生检验杂志》2022年第1期91-94,共4页Chinese Journal of Health Laboratory Technology

基　　金：温州市基础性医疗卫生科技项目(Y20210341)。

摘　　要：目的探讨未足月胎膜早破(PPROM)孕妇发生组织学绒毛膜羊膜炎(HCA)的危险因素,评价不同指标对PPROM孕妇发生HCA的预测能力。方法回顾性分析2015年1月—2020年6月本院产科住院分娩的480例PPROM孕妇的临床资料。根据产后胎盘病理检查结果分为HCA组(326例)和非HCA组(154例),采用Logistic回归分析确定PPROM孕妇发生HCA的高危因素,并以ROC曲线预测不同指标对PPROM孕妇合并HCA的诊断预测能力。结果 480例POM孕妇发生HCA 326例,HCA发生率为67.92%;潜伏期、破膜孕周及血清单核细胞趋化蛋白-1(MCP-1)、血清淀粉样蛋白(SAA)、肾上腺髓质素前体(pro-ADM)水平增高是PPROM孕妇发生HCA的独立危险因素(P<0.05)。联合血清MCP-1、SSA和pro-ADM3项指标预测发生HCA的ROC曲线下面积(AUC)为0.894,敏感度为80.98%,特异度为81.82%,诊断效率优于单一指标。结论 PPROM孕妇发生HCA的危险因素较多,临床针对相关危险因素采取早期预防,减少PPROM孕妇HCA的发生概率,降低孕妇和新生儿各种疾病发生率和死亡率。Objective To explore the risk factors of histological chorioamnionitis(HCA) in preterm premature rupture of membranes(PPROM), and to evaluate the predictive ability of different indicators for HCA in PPROM women.Methods A retrospective analysis was conducted on the clinical data from 480 cases of PPROM parturients who gave birth in the obstetrics department of our hospital from January 2015 to June 2020. And they were divided into HCA group(326 cases) and non-HCA group(154 cases) according to the results of postpartum placenta pathology. Logistic regression analysis was used to determine the high risk factors for HCA in PPROM women, and ROC curve was used to predict the ability to predict the diagnosis of PPROM women with HCA.Results There were 326 cases of HCA in 480 women with POM, and the incidence of HCA was67. 92%;the incubation period, rupture of the membrane and gestational age, serum monocyte chemoattractant protein-1(MCP-1), serum amyloid protein(SAA), adrenal medulla increased pro-ADM level are independent risk factors for HCA in PPROM women(P< 0. 05). Combined with serum MCP-1, SSA and pro-ADM, the area under the ROC curve(AUC)for predicting the occurrence of HCA was 0. 894, the sensitivity was 80. 98%, the specificity was 81. 82%, and the diagnostic efficiency was better than a single index.Conclusion There are many risk factors for HCA in PPROM women. Early prevention of related risk factors should be adopted in clinical practice to reduce the incidence of HCA in PPROM women and reduce the incidence and mortality of various diseases and deaths of women and newborns.

关 键 词：未足月胎膜早破 组织学绒毛膜羊膜炎 危险因素 预测指标 ROC曲线 

分 类 号：R7I4.56[医药卫生—临床医学]