β-HCG及sPLA2和单核细胞TLR4在胎膜早破合并宫内感染中的表达水平及其诊断价值  

Expression levels of β-HCG, sPLA2 and monocyte TLR4 in premature rupture of membranes combined with intrauterine infection and their diagnostic value

作　　者：丁丽娟 陈晨 王妮 钱丽 周金玲 DING Li-juan;CHEN Chen;WANG Ni;QIAN Li;ZHOU Jin-ling(The Affiliated Wuri People's Hospital of Nanjing Medical University,Wuri Medical Center,Nanjing Medical University,Wuri,Jiangsu 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院,南京医科大学无锡医学中心妇产科,江苏无锡214023

出　　处：《中华医院感染学杂志》2023年第24期3780-3784,共5页Chinese Journal of Nosocomiology

基　　金：无锡市卫生健康委妇幼健康科研项目(FYKY202202)。

摘　　要：目的 探究人绒毛膜促性腺激素β(β-HCG)、人分泌型磷脂酶A2(sPLA2)、单核细胞Toll样受体4(TLR4)在胎膜早破合并宫内感染中的表达水平及其诊断价值。方法 回顾性分析无锡市人民医院2020年2月-2022年10月收治的116例胎膜早破孕妇的临床资料,根据是否发生宫内感染,将其分为感染组(34例)和未感染组(82例),另选116名同期体检健康的孕妇作为健康对照组,比较三组血清β-HCG、sPLA2、单核细胞TLR4水平;根据不同感染程度,将感染组分为轻度组、中度组和重度组,比较三组血清β-HCG、sPLA2、单核细胞TLR4水平,采用Spearman相关性分析血清β-HCG、sPLA2、单核细胞TLR4水平与宫内感染程度的相关性;采用受试者工作特征(ROC)曲线分析血清β-HCG、sPLA2、单核细胞TLR4水平单一及联合检测对胎膜早破孕妇宫内感染的诊断价值。结果 感染组和未感染组血清β-HCG、sPLA2、单核细胞TLR4水平均高于健康对照组(P<0.05),且感染组高于未感染组(P<0.05);中度组、重度组血清β-HCG、sPLA2、单核细胞TLR4水平高于轻度组(P<0.05),且重度组高于中度组(P<0.05);血清β-HCG、sPLA2、单核细胞TLR4水平与宫内感染程度均呈正相关(P<0.05);血清β-HCG、sPLA2、单核细胞TLR4水平联合检测诊断胎膜早破孕妇宫内感染的AUC值高于单一检测(P<0.05)。结论 血清β-HCG、sPLA2、单核细胞TLR4在胎膜早破孕妇发生宫内感染时水平升高,三者水平与其宫内感染程度均呈正相关,且三者联合检测可提高胎膜早破孕妇宫内感染的诊断价值。OBJECTIVE To investigate the expression levels of human chorionic gonadotropin β(β-hCG), human secretory phospholipase A2(sPLA2), and toll-like receptor 4(TLR4) in monocytes of pregnant women with premature rupture of membranes combined with intrauterine infection and their diagnostic value. METHODS Clinical data of 116 pregnant women with premature rupture of membranes admitted to Wuxi People′s Hospital from Feb 2020 to Oct 2022 were retrospectively analyzed. According to whether intrauterine infection occurred, they were divided into the infected group(34 cases) and the uninfected group(82 cases), and 116 healthy pregnant women in the same period were enrolled as the healthy control group. Serum β-HCG, sPLA2 and monocyte TLR4 levels were compared among the three groups. According to different degrees of infection, the infection group was subdivided into the mild group, moderate group and severe group. The serum β-HCG, sPLA2 and monocyte TLR4 levels among the three groups were compared, and the correlation of serum β-HCG, sPLA2 and monocyte TLR4 levels with the degree of intrauterine infection was analyzed by spearman correlation. Receiver operating characteristic curve(ROC) was used to analyze the diagnostic value of serum β-HCG, sPLA2 and monocyte TLR4 levels in the individual and combined detection for intrauterine infection in pregnant women with premature rupture of membranes. RESULTS The levels of serum β-HCG, sPLA2 and monocyte TLR4 in the infected and uninfected groups were higher than those in the healthy control group(P<0.05), and those in the infected group was higher than those in the uninfected group(P<0.05). The levels of serum β-HCG, sPLA2 and monocyte TLR4 in the moderate and severe groups were higher than those in the mild group(P<0.05);and those in the severe group was higher than those in the moderate group(P<0.05). The levels of serum β-HCG, sPLA2 and TLR4 in monocytes were positively correlated with the degree of intrauterine infection(P<0.05). The AUC value of serum β-HCG, sPLA2

关 键 词：胎膜早破 宫内感染 人绒毛膜促性腺激素β 人分泌型磷脂酶A2 Toll样受体4 受试者工作特征曲线 诊断价值 

分 类 号：R714.433[医药卫生—妇产科学]