血清PCT、HBD-2、CRP水平和B族链球菌阳性率对未足月胎膜早破合并羊膜腔感染的诊断价值  

The diagnostic value of serum levels of pro calcitonin,β2 defensins,C-reactive protein and the positive rate of group B streptococci in preterm premature rupture of membranes with amniotic infection

作　　者：白建萍 周建政[2] 罗玲 Bai Jianping;Zhou Jianzheng;Luo Ling(Department of Obstetrics,the Hospital of Southern University of Science and Technology,Shenzhen 518000,China;Department of Obstetrics and Gynecology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]南方科技大学医院产科,深圳518000 [2]山西医科大学第二医院妇产科,太原030001

出　　处：《中国医师杂志》2023年第7期1030-1033,共4页Journal of Chinese Physician

基　　金：白求恩公益基金(BCF-HE-SY-20200511-009)。

摘　　要：目的探讨血清降钙素原(PCT)、β2防御素(HBD-2)、C反应蛋白(CRP)水平和B族链球菌(GBS)阳性率对未足月胎膜早破(PROM)合并羊膜腔感染的诊断价值。方法本研究为回顾性研究,选取2017年1月至2022年1月南方科技大学医院产科确诊的156例未足月PROM产妇作为研究对象,根据是否发生羊膜腔感染分为感染组57例、非感染组99例,对比两组研究对象分娩前的血清PCT、HBD-2、CRP水平,检测阴道分泌物GBS阳性率,并采用受试者工作曲线(ROC)分析各项指标诊断未足月PROM产妇发生羊膜腔感染的价值。结果感染组患者的血清PCT、HBD-2、CRP水平及GBS阳性率均显著高于非感染组患者,差异有统计学意义(均P<0.01);血清PCT诊断未足月PROM合并羊膜腔感染的AUC值为0.894、灵敏度为82.56%、特异度为80.74%;HBD-2诊断未足月PROM合并羊膜腔感染的AUC值为0.792、灵敏度为70.78%、特异度为77.59%;CRP诊断未足月PROM合并羊膜腔感染的AUC值为0.756、灵敏度为68.94%、特异度为72.78%;阴道分泌物中GBS阳性率诊断未足月PROM合并羊膜腔感染的AUC值为0.733、灵敏度为64.91%、特异度为81.82%。结论未足月PROM合并羊膜腔感染产妇血清PCT、HBD-2、CRP水平会显著增高,阴道分泌物中GBS阳性率增高,各项指标对于诊断未足月PROM合并羊膜腔感染具有较高的实用价值。Objective To explore the diagnostic value of serum levels of pro calcitonin(PCT),β2 defensins(HBD-2),C-reactive protein(CRP)and the positive rate of group B streptococci(GBS)in preterm premature rupture of membranes(PROM)with amniotic infection.Methods This study was a retrospective study.156 pregnant women with preterm PROM who were diagnosed by the Obstetrics Department of the Hospital of Southern University of Science and Technology from January 2017 to January 2022 were selected as the study subjects.According to whether there was amniotic infection,they were divided into 57 infected women and 99 non infected women.The levels of serum PCT,HBD-2 and CRP before delivery were compared between the two groups,and the positive rate of GBS in vaginal discharge was detected,and the receiver operating curve(ROC)was used to analyze the value of various indicators in diagnosing amniotic cavity infection in preterm PROM mothers.Results The serum levels of PCT,HBD-2,CRP,and GBS positivity in the infected group were significantly higher than those in the non infected group,with statistically significant differences(all P<0.01);The area under the curve(AUC)value,sensitivity,and specificity of serum PCT for diagnosing preterm PROM with amniotic cavity infection were 0.894,82.56%,and 80.74%,respectively;The AUC value of HBD-2 for diagnosing preterm PROM with amniotic cavity infection was 0.792,the sensitivity was 70.78%,and the specificity was 77.59%;The AUC value,sensitivity,and specificity of CRP in diagnosing preterm PROM with amniotic cavity infection were 0.756,68.94%,and 72.78%,respectively;The positive rate of GBS in vaginal discharge was 0.733,the sensitivity was 64.91%,and the specificity was 81.82%.Conclusions The serum levels of PCT,HBD-2,CRP and the positive rate of GBS in vaginal discharge of pregnant women with preterm PROM complicated with amniotic infection will increase significantly.All indicators have high practical value for the diagnosis of preterm PROM complicated with amniotic infection.

关 键 词：胎膜早破 羊膜腔感染 链球菌 B族 降钙素原 β2防御素 C反应蛋白质 

分 类 号：R714.433[医药卫生—妇产科学]