外周血sTREM-1联合MIP-1α预测胎膜早破孕妇急性宫内感染中的价值  

Value of peripheral blood sTREM-1 combined with MIP-1α in predicting acute intrauterine infection in pregnant women with premature rupture of membranes

作　　者：杨莉莉 陈自力 张永展 刘蓝泽 陈静 李艳梅 陈红晓 卢慧 YANG Li-li;CHEN Zi-li;ZHANG Yong-zhan;LIU Lan-ze;CHEN Jing;LI Yan-mei;CHEN Hong-xiao;LU Hui(Tianjin Fifth Central Hospital(Peking UUniversity Binhai Hospital),Tianjin 300450,China)

机构地区：[1]天津市第五中心医院(北京大学滨海医院)妇产科,天津300450

出　　处：《中华医院感染学杂志》2024年第15期2368-2371,共4页Chinese Journal of Nosocomiology

基　　金：天津市滨海新区卫生计生委科技项目(2015BWKZ003)。

摘　　要：目的分析外周血可溶性髓样细胞触发受体-1(sTREM-1)联合巨噬细胞炎性蛋白-1α(MIP-1α)预测胎膜早破孕妇急性宫内感染中的价值.方法回顾性分析2020年2月—2023年2月天津市第五中心医院产科92例胎膜早破孕妇的临床资料,根据患儿是否合并宫内感染分为宫内感染组36例与非宫内感染组56例;统计宫内感染组宫颈分泌物病原学分布特点,分析宫内感染组与非宫内感染组血清sTREM-1及MIP-1α水平差异,并利用受试者工作特征(ROC)曲线分析sTREM-1及MIP-1α诊断宫内感染的临床价值.结果36例宫内感染组孕妇宫颈分泌物共检测出35株病原菌,其中革兰阴性菌20株占57.14%,革兰阳性菌13株占37.14%,真菌2株占5.71%;宫内感染组血清sTREM-1及MIP-1α水平高于非宫内感染组(P<0.05);ROC曲线分析结果血清sTREM-1、MIP-1α对宫内感染均具有较高诊断价值[曲线下面积(AUC)=0.840、0.911],二指标联合诊断价值更高(AUC=0.938).结论血清sTREM-1和MIP-1α水平预测胎膜早破孕妇是否发生宫内感染具有较高的灵敏性和特异性,可为早期诊断提供参考价值.OBJECTIVE To explore the value of peripheral blood soluble myeloid cell trigger receptor-1(sTREM-1)combined with macrophage inflammatory protein-1α(MIP-1α)in predicting acute intrauterine infection in pregnant women with premature rupture of fetal membrane.METHODS The clinical data of 92 pregnant women with pre-mature rupture of membranes in the obstetric department of Tianjin Fifth Central Hospital from Feb 2020 to Feb 2023 were retrospectively analyzed.According to whether the children were combined with intrauterine infection,they were divided into the intrauterine infection group(36 cases)and non-intrauterine infection group(56 cases).The distribution of pathogens from cervical secretions in the intrauterine infection group were analyzed,and the differences in serum sTREM-1 and MIP-1αlevels between the intrauterine infection group and the non-intrauterine infection group were compared.The clinical value of sTREM-1 and MIP-1αin the diagnosis of intrauterine infec-tion was analyzed by receiver operating characteristics(ROC)curve.RESULTS A total of 35 strains of pathogenic bacteria were detected in cervical secretions of the intrauterine infection group with 36 cases,including gram-nega-tive bacteria(57.14%),gram-positive bacteria(37.14%)and fungi(5.71%).The levels of serum sTREM-1 and MIP-1αin the intrauterine infection group were significantly higher than those in the non-intrauterine infection group(P<0.05).ROC curve analysis showed that serum sTREM-1 and MIP-1αhad high diagnostic value in in-trauterine infection[area under the curve(AUC)=0.840,0.911].The diagnostic value of STREM-1 combined with MIP-1αwas higher(AUC=0.938).CONCLUSION Serum sTREM-1 and MIP-1αlevels have high sensitivity and specificity in predicting intrauterine infection in pregnant women with premature rupture of membranes,which can provide reference value for early diagnosis.

关 键 词：可溶性髓样细胞触发受体-1 巨噬细胞炎性蛋白-1Α 胎膜早破 宫内感染 预测价值 

分 类 号：R714.433[医药卫生—妇产科学]