胎膜早破孕妇血清金属蛋白酶9和白细胞介素6在预测绒毛羊膜炎中的作用

Maternal serum matrix metalloproteinase-9 and interleukin-6 in predicting chorioamnhionitis in patients with premature rupture of membranes

目的:评价胎膜早破孕妇血中金属蛋白酶9(MMP 9)及白细胞介素6(IL 6)预测绒毛羊膜炎的作用。方法:采用酶联免疫吸附法(ELISA)检测50例胎膜早破无妊娠并发症及合并症孕妇血清中MMP 9和IL 6水平,同时行胎膜病检。结果:胎膜早破并绒毛羊膜炎孕妇MMP 9和IL 6含量明显高于非绒毛羊膜炎孕妇(P<0. 01)。应用血清中MMP 9水平115. 0ng/ml和IL 6水平68. 5ng/ml为临界点,其灵敏度、特异性、阳性预测值和阴性预测值分别为89. 7%和86. 2%, 71. 4%和66. 7%, 81. 2%和78. 1%, 83. 3%和77. 8%。结论:血清MMP 9在预测绒毛羊膜炎时比IL 6具有更高敏感性、特异性、阳性及阴性预测值。

Objective To assess the potential role of maternal serum matrix metalloproteinase-9 and interleukin-6 in predicting chorioamnhionitis in patients with premature rupture of membranes (PROM). Methods Fifty women with singleton gestations PROM were studied.We excluded women with complications. Maternal serum matrix metalloproteinase-9 and interleukin-6 levels were measured by enzyme-labeled immunosorbent assay. Chorioamnhionitis was diagnosed histologically. Results Maternal serum matrix metalloproteinase-9 and interleukin-6 levels were significantly higher in women with chorioamnhionitis than in those without ( P<0.01 ). Using maternal serum cutoff levels of 115.0 ng/ml for matrix metalloproteinase-9 and 68.5 ng/ml for interleukin-6, the sensitivity, specificity, and positive and negative predictive values for diagnosing chorioamnhionitis were 89.7% versus 86.2%, 71.4% versus 66.7%,81.2% versus 78.1%, and 83.3% versus 77.8%, respectively. Conclusion Maternal serum matrix metalloproteinase-9 is an accurate biochemical marker in predicting chorioamnhionitis with better sensitivity, specificity, and positive and negative predictive values than interleukin-6.