内脂素、多项血清因子预测宫内感染的意义

Clinical significance of visfatin and serum factors in predicting intrauterine infection

目的通过检测胎膜早破患者母血、脐血中内脂素、多项流式细胞因子及白细胞计数、c-反应蛋白（CRP）的水平，探讨其在胎膜早破及宫内感染过程中可能的病理生理机制及相关意义。方法选择胎膜早破确诊宫内感染患者30例为研究组A；选取胎膜早破非宫内感染患者30例为阳性对照纽B；另选取定期产检的正常孕妇30例为阴性对照纽c，分析3组间胎膜早破与宫内感染的关系。结果研究组母血中白介素-6、白细胞、CRP、内脂素均明显高于对照组B（t值分别为2．488、5．386、3．843、4．347，均P〈0．05）。母血CRP、白细胞、白介素-6及内脂素的曲线下面积（AUC）分别为：0．819、0．830、0．753、0．784，与诊断宫内感染的金标准病理组织学诊断相比较，4个指标均在0．7～0．9之间，有一定的准确性。结论母血内脂素及白介素-6的检测对于预测胎膜早破患者宫内感染有重要意义。

Objective To probe into the possible pathophysiologieal mechanism and significance of visfatin, flow cell factors, white blood cell counts and C reactive protein （CRP） level in premature rupture of fetal membranes and intrauterine infection by detecting their levels in maternal and umbilical cord blood. Methods Thirty cases of premature rupture of membranes with diagnosed intrauterine infection were selected in study group A, 30 cases of premature rupture of membranes without intrauterine infection were selected in positive control group B, and 30 cases of normal pregnant women taking regular check up were selected in negative control group C. The relationship between premature rupture of membranes and intrauterine infection in these 3 groups was analyzed. Results Interleukin-6 （ IL-6 ）, white blood cell, CRP and visfatin in maternal blood in study group A were significantly higher than those in control group B （t value was 2. 488, 5. 386, 3. 843 and 4. 347, respectively, all P 〈 0.05）. Area under curve （AUC） of maternal serum CRP, white blood cells, IL-6 and visfatin was 0. 819, 0. 830, 0. 753 and 0. 784, respectively. When they were compared with the histopathological diagnosis, the gold standard in diagnosis of intrauterine infection, these four values were between 0.7-0.9, which had certain accuracy. Conclusion The detection of visfatin and IL-6 in maternal blood is important in predicting intrauterine infection in patients with premature rupture of membranes.