孕中晚期超声胎膜厚度联合血清IL-6、C反应蛋白预测早产发生的临床价值  

Clinical value of ultrasonic fetal membrane thickness combined with serum IL-6 and CRP in predicting premature delivery in the second and third trimesters of pregnancy

作　　者：刘德永 汪劲松 郑智超[1] 何嘉辉 姚公志 LIU Deyong;WANG Jinsong;ZHENG Zhichao;HE Jiahui;YAO Gongzhi(Department of Ultrasound,Nanhai Hospital,Guangdong Provincial People's Hospital,Foshan 528200,China)

机构地区：[1]广东省人民医院南海医院超声科,广东佛山528200

出　　处：《分子影像学杂志》2022年第3期424-428,共5页Journal of Molecular Imaging

基　　金：佛山市卫生局项目(20200393)。

摘　　要：目的 探讨孕中晚期超声胎膜厚度检测联合血清白介素-6(IL-6)、C反应蛋白(CRP)预测早产发生的临床价值。方法 收集2019年1月1日~2020年12月31日于我院建档进行产检和分娩的599例孕妇作为研究对象,根据分娩时间将孕妇分为早产组(n=86)和足月组(n=513),分析两组孕妇孕中、晚期血清IL-6、CRP及超声胎膜厚度,采用ROC曲线分析上述3项指标对孕妇早产的预测价值,并比较两组孕妇通过各指标诊断的阳性率。结果 在孕23~25周和孕32~34周,早产组孕妇血清IL-6、CRP水平高于足月组(P<0.05),胎膜厚度低于足月组(P<0.05);ROC曲线分析结果显示,超声胎膜厚度联合血清IL-6、CRP预测早产的ROC曲线下面积高于3项指标单独预测的ROC曲线下面积(P<0.05);且联合预测的准确度、敏感度和特异性均较高。早产组孕妇血清IL-6、CRP和胎膜厚度单项诊断和联合诊断早产的阳性率均高于足月组(P<0.05)。结论 与足月生产孕妇比较,早产孕妇中晚期的血清IL-6、CRP水平明显更高,胎膜厚度更高,联合检测血清IL-6、CRP和胎膜厚度对于预测孕妇早产具有较高的应用价值。Objective To explore the clinical value of ultrasonic fetal membrane thickness combined with serum interleukin-6(IL-6) and C-reactive protein(CRP) in predicting premature delivery in the second and third trimesters of pregnancy. Methods A total of 599 pregnant women undergoing prenatal examination and delivery in the hospital were enrolled as the research objects from January 1 st, 2019 to December 31 st, 2020. According to different delivery time, they were divided into premature delivery group(n=86) and full-term group(n=513). The serum IL-6, CRP and ultrasonic fetal membrane thickness in both groups were analyzed in the second and third trimesters of pregnancy. The predictive value of the above three indexes for premature delivery was analyzed by ROC curves. The positive rates of different indexes were compared between the two groups. Results Within 23-25 and 32-34 gestational weeks, levels of serum IL-6 and CRP in premature delivery group were significantly higher than those in full-term group(P<0.05), while thickness of fetal membranes was thinner than that in fullterm group(P<0.05). The ROC curves analysis showed that the area under the ROC curve of ultrasonic fetal membrane thickness combined with serum IL-6 and CRP for predicting premature delivery was greater than that of single index(P<0.05).The accuracy, sensitivity and specificity of combined prediction were higher. The positive rates of premature delivery by single diagnosis and combined diagnosis in premature delivery group were higher than those in full-term group(P<0.05).Conclusion Compared with full-term pregnant women, levels of serum IL-6 and CRP are significantly higher, and thickness of fetal membranes is thicker in pregnant women with premature deliver in the second and third trimesters. The combined detection of serum IL-6, CRP and fetal membrane thickness has higher predictive value for premature delivery.

关 键 词：早产 宫内感染 孕中晚期 胎膜厚度 白介素-6 C反应蛋白 

分 类 号：R714.21[医药卫生—妇产科学]