细胞因子联合凝血指标在孕妇胎膜早破诊断中的作用  

The Role of Cytokines Combined with Coagulation Indexes in the Diagnosis of Premature Rupture of Membranes in Pregnant Women

作　　者：谢尹晶 林应 陈银燕 于昊彤 史菲 陈卫布 XIE Yin-jing;LIN Ying;CHEN Yin-yan;YU Hao-tong;SHI Fei;CHEN Wei-bu(Department of Laboratory,Shenzhen People's Hospital/2nd Clinical Medical College of Jinan University/1st Affliated Hospital of South University of Science and Technology,Shenzhen 518020,Guangdong,China;Department of Emergency,Shenzhen People's Hospital/2nd Clinical Medical College of Jinan University/1st Affliated Hospital of South University of Science and Technology,Shenzhen 518020,Guangdong,China)

机构地区：[1]深圳市人民医院/暨南大学第二临床医学院/南方科技大学第一附属医院检验科,广东深圳518020 [2]深圳市人民医院/暨南大学第二临床医学院/南方科技大学第一附属医院急诊科,广东深圳518020

出　　处：《医学信息》2023年第8期116-119,共4页Journal of Medical Information

基　　金：广东省省级科技计划项目(编号:2016A020215025)。

摘　　要：目的探讨细胞因子和凝血指标与胎膜早破的关系及其诊断价值。方法选取2020年8月-11月深圳市人民医院收治的胎膜早破孕妇31例为胎膜早破组,同期健康孕妇23例为对照组,比较两组白细胞介素1β(interleukin-1β,IL-1β)、IL-6、IL-8、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和凝血指标[凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、抗凝血酶Ⅲ(ATⅢ)、D-二聚体(D-D)、血小板计数(PLT)],并采用多因素Logistic回归分析胎膜早破的独立影响因素,ROC曲线分析各指标诊断胎膜早破的价值。结果胎膜早破组TNF-α水平高于对照组,差异有统计学意义(P<0.05);而两组IL-1β、IL-6、IL-8和IL-10水平比较,差异无统计学意义(P>0.05);胎膜早破组ATⅢ高于对照组,差异有统计学意义(P<0.05);两组PT、APTT、TT、FIB、D-D和PLT比较,差异无统计学意义(P>0.05);多因素Logistic回归分析显示,TNF-α和ATⅢ为胎膜早破孕妇的独立影响因素;ROC曲线分析显示,TNF-α联合ATⅢ诊断孕妇胎膜早破的价值较高,AUC为0.834(0.711~0.957),其敏感性为73.90%,特异性为82.40%。结论TNF-α和ATⅢ联合应用有利于早期诊断孕妇胎膜早破。Objective To investigate the relationship between cytokines and coagulation indexes and premature rupture of membranes and its diagnostic value.Methods From August to November 2020,31 pregnant women with premature rupture of membranes admitted to Shenzhen People's Hospital were selected as premature rupture of membranes group,and 23 healthy pregnant women were selected as control group.Cytokines[interleukin-1β(IL-1β),IL-6,IL-8,IL-10,tumor necrosis factor-α(TNF-α)]and coagulation indexes[thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),antithrombin Ⅲ(ATⅢ),D-dimer(D-D),platelet count(PLT)]were compared between the two groups.Multivariate Logistic regression was used to analyze the independent influencing factors of premature rupture of membranes,and ROC curve was used to analyze the value of each index in the diagnosis of premature rupture of membranes.Results The level of TNF-α in the premature rupture of membranes group was higher than that in the control group,and the difference was statistically significant(P<0.05),while there was no significant difference in the levels of IL-1β,IL-6,IL-8 and IL-10 between the two groups(P>0.05).The ATⅢ in the premature rupture of membranes group was higher than that in the control group,and the difference was statistically significant(P<0.05),while there was no significant difference in PT,APTT,TT,FIB,D-D and PLT between the two groups(P>0.05).Multivariate Logistic regression analysis showed that TNF-α and ATⅢ were independent influencing factors for pregnant women with premature rupture of membranes.ROC curve analysis showed that TNF-α combined with ATⅢ had a higher value in the diagnosis of premature rupture of membranes in pregnant women,with AUC of 0.834(0.711-0.957),sensitivity of 73.90% and specificity of 82.40%.Conclusion The combined application of TNF-α and ATⅢ is beneficial to the early diagnosis of premature rupture of membranes in pregnant women.

关 键 词：胎膜早破 细胞因子 白细胞介素 肿瘤坏死因子 凝血指标 

分 类 号：R714.433[医药卫生—妇产科学]