β-HCG、CRP和TNF-α联合检测在胎膜早破宫内感染中的预测作用  

Predictive role of combined detection ofβ-HCG,CRP and TNF-αin intrauterine infection in premature rupture of membranes

作　　者：狄红丽 郝树磊[1] 杨彩凤[1] 刘蓬[1] DI Hongli;HAO Shulei;YANG Caifeng;LIU Peng(Department of Obstetrics,Baoding Second Central Hospital,Baoding,Hebei,China,072750)

机构地区：[1]保定市第二中心医院产科,河北保定072750

出　　处：《分子诊断与治疗杂志》2022年第3期483-486,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫计委医学科学研究重点课题(20180257)。

摘　　要：目的分析血清β-人绒毛膜促性腺激素(β-HCG)、C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)联合检测在胎膜早破早期宫内感染中的预测作用。方法收集保定市第二中心医院2018年1月至2020年8月收治的124例胎膜早破孕妇的临床资料,根据是否合并感染分为感染组、未感染组,另选取同时期52例足月分娩孕妇作为对照组。分析各组血清β-HCG、CRP、TNF-α水平;比较不同感染程度胎膜早破孕妇血清β-HCG、CRP、TNF-α水平及其与胎膜早破宫内感染程度的相关性。绘制受试者工作特征曲线(ROC),分析β-HCG、CRP、TNF-α联合检测对胎膜早破患孕妇宫内感染的预测价值。结果124例患者中,合并宫内感染58例(感染组)。β-HCG、CRP及TNF-α水平:对照组<未感染组<感染组,差异均有统计学意义(P<0.05)。48例胎膜早破合并宫内感染孕妇中,轻度感染21例(轻度组),中度感染18例(中度组),重度感染9例(重度组)。胎膜早破合并宫内感染孕妇血清β-HCG、CRP、TNF-α水平:轻度组<中度组<重度组,差异均有统计学意义(P<0.05)。相关性分析显示,血清β-HCG、CRP、TNF-α水平与感染严重程度均呈显著正相关性(P<0.05)。ROC曲线分析结果显示,β-HCG、CRP、TNF-α诊断临界值分别为33.84 m IU/mL、10.89 mg/L、537.12 pg/mL,β-HCG、CRP、TNF-α联合检测预测胎膜早破合并宫内感染的下曲线面积(AUC)、敏感度、特异度均高于单一检测(P<0.05)。结论胎膜早破合并宫内感染孕妇血清β-HCG、CRP及TNF-α水平呈异常表达,联合检测上述因子有助于提高胎膜早破合并宫内感染的预测价值。Objective To analyze the predictive effect of serumβ⁃human chorionic gonadotropin(β⁃HCG),C⁃reactive protein(CRP),Tumor necrosis factor⁃α(TNF⁃α)combined detection in the early intrauterine infection of premature rupture of membranes.Methods The clinical data of 124 pregnant women with premature rupture of membranes admitted to Baoding Second Central Hospital from January 2018 to August 2020 were collected.According to whether they were co⁃infected or not,they were divided into the infected group and the non⁃infected group,and 52 pregnant women who gave birth in the same period were selected as the control group.The serum levels ofβ⁃HCG,CRP,and TNF⁃αin each group were analyzed.The levels of serumβ⁃HCG,CRP,and TNF⁃αin pregnant women with premature rupture of placenta infection and their correlation with the degree of intrauterine infection of premature rupture of membranes were compared.The receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of combined detection ofβ⁃HCG,CRP,and TNF⁃αon intrauterine infection in pregnant women with premature rupture of placenta.Results Among the 124 patients,58 were complicated with intrauterine infection(infected group).The levels ofβ⁃HCG,CRP and TNF⁃αin each group:the control group<the uninfected group<the infected group,the difference was statistically significant(P<0.05).Among the 48 pregnant women with premature rupture of membranes and intrauterine infection,21 had mild infection(mild group),18 had moderate infection(moderate group),and 9 had severe infection(severe group).The serum levels ofβ⁃HCG,CRP and TNF⁃αin pregnant women with premature rupture of placenta and intrauterine infection:mild group<moderate group<severe group,the difference was statistically significant(P<0.05).Correlation analysis showed that serumβ⁃HCG,CRP,TNF⁃αlevels were significantly positively correlated with the severity of infection(P<0.05).The ROC curve analysis results showed that the diagnostic cut⁃off values

关 键 词：血清β-人绒毛膜促性腺激素 C反应蛋白 肿瘤坏死因子-Α 胎膜早破 宫内感染 

分 类 号：R714.433[医药卫生—妇产科学]