血清IL-6、PCT、CRP、WBC、NEU在诊断未足月胎膜早破合并亚临床绒毛膜羊膜炎中的应用  

Application of Serum IL-6,PCT,CRP,WBC and NEU in the Diagnosis of Preterm Premature Rupture of Membranes with Subclinical Chorioamnionitis

作　　者：李昌菊 李赛男[2] 祁文瑾[2] 马存丽[1] LI Chang-ju;LI Sai-nan;QI Wen-jin;MA Cun-li(Department of Obstetrics,People's Hospital of Yuxi City,Yuxi 653100,Yunan,China;Department of Obstetrics,First Affiliated Hospital of Kunming Medical University,Kunming 650000,Yunnan,China)

机构地区：[1]玉溪市人民医院产科,云南玉溪653100 [2]昆明医科大学第一附属医院产科,云南昆明650000

出　　处：《医学信息》2023年第9期102-105,共4页Journal of Medical Information

基　　金：云南省医学领军人才培养项目(编号:L-2017023)。

摘　　要：目的探讨白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞比例(NEU)及联合检测在诊断未足月胎膜早破(PPROM)合并亚临床绒毛膜羊膜炎(SCA)的应用。方法选取2018年10月-2021年12月玉溪市人民医院收治的PPROM产妇251例,据胎盘病理检查结果分为PPROM无绒毛膜羊膜炎组(A组)126例、PPROM合并SCA组(B组)70例、PPROM合并CAM组(C组)55例。比较各组血清WBC、NEU、C-RP、IL-6及PCT水平,并采用ROC曲线评估各指标及联合检测对诊断PPROM合并SCA的价值。结果3组产妇血清WBC、NEU、CRP、IL-6、PCT水平比较,差异有统计学意义(P<0.05),其中B组血清WBC、NEU、CRP、IL-6水平高于A组(P<0.05),C组血清WBC、NEU、CRP、IL-6、PCT水平高于A组(P<0.05),C组CRP、IL-6、PCT水平高于B组(P<0.05),而A、B组血清PCT水平比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,IL-6+CRP、IL-6+CRP+WBC+NEU的AUC高于以上单一指标,其AUC分别为0.855、0.786。结论血清WBC、NEU、CRP、IL-6单项检测是诊断PPROM合并SCA的重要指标,而IL-6、NEU、WBC、CRP联合检测价值更高,可进一步为合并SCA的PPROM患者早期提供诊断依据,对临床诊疗方案制定具有重要参考价值。Objective To investigate the application of interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein(CRP),white blood cell count(WBC),neutrophil ratio(NEU)and combined detection in the diagnosis of preterm premature rupture of membranes(PPROM)with subclinical chorioamnionitis(SCA).Methods A total of 251 pregnant women with PPROM admitted to People's Hospital of Yuxi City from October 2018 to December 2021 were selected.According to the results of placental pathological examination,they were divided into PPROM without chorioamnionitis group(group A)126 cases,PPROM with SCA group(group B)70 cases,PPROM with CAM group(group C)55 cases.The levels of serum WBC,NEU,C-RP,IL-6 and PCT in each group were compared,and the value of each index and combined detection in the diagnosis of PPROM combined with SCA was evaluated by ROC curve.Results There were significant differences in the levels of serum WBC,NEU,CRP,IL-6 and PCT among the three groups(P<0.05),while the levels of serum WBC,NEU,CRP and IL-6 in group B were higher than those in group A(P<0.05);the levels of serum WBC,NEU,CRP,IL-6 and PCT in group C were higher than those in group A(P<0.05);the levels of CRP,IL-6 and PCT in group C were higher than those in group B(P<0.05);there was no significant difference in the levels of serum PCT between group A and group B(P>0.05).ROC curve analysis showed that the AUC of IL-6+CRP and IL-6+CRP+WBC+NEU was higher than that of the above single index,and the AUC was 0.855 and 0.786,respectively.Conclusion The single detection of serum WBC,NEU,CRP and IL-6 is an important index for the diagnosis of PPROM combined with SCA,and the combined detection of IL-6,NEU,WBC and CRP is of higher value,which can further provide early diagnosis basis for PPROM patients with SCA,and has important reference value for the formulation of clinical diagnosis and treatment plan.

关 键 词：未足月胎膜早破 绒毛膜羊膜炎 白细胞介素-6 降钙素原 C-反应蛋白 白细胞计数 中性粒细胞比例 

分 类 号：R714.2[医药卫生—妇产科学]