C反应蛋白、宫颈分泌物涂片联合检测对未足月胎膜早破绒毛膜羊膜炎诊断的临床价值

Clinical significance of combined detection of C reactive protein and cervical secretion smear in chorioamnlonitis with preterm premature rupture of membranes

目的探讨联合检测C反应蛋白、宫颈分泌物细菌涂片对未足月胎膜早破（PPROM）合并绒毛膜羊膜炎诊断的临床价值。方法通过对80例PPROM（PPROM组）患者C反应蛋白测定及宫颈分泌物细菌涂片检查，将诊断为绒毛膜羊膜炎55例及无绒毛膜羊膜炎25例做为研究对象分析C反应蛋白及宫颈细菌涂片检查结果的敏感性、特异性、阳性预测值、阴性预测值，同时选择相同孕周的未足月无胎膜早破孕妇60例作为PPROM组的对照组。结果PPROM组C反应蛋白及宫颈分泌物细菌涂片的阳性率均高于对照组，差异均有统计学意义（x2值分别为50．24、54．81，P均〈0．05）。C反应蛋白诊断未足月胎膜早破患者80例的绒毛膜羊膜炎的敏感性、特异性、阳性预测值、阴性预测值分别为58．18％、63．64％、36．00％、32．00％，宫颈分泌物细菌涂片分别为66．67％、67．31％、29．03％、28．57％，C反应蛋白及宫颈分泌物细菌涂片两者同时阳性诊断绒毛膜羊膜炎的敏感性、特异性、阳性预测值、阴性预测值分别为69．09％、88．00％、92．68％、56．41％。结论联合检测C反应蛋白及宫颈分泌物细菌涂片可提高对PPROM孕妇合并绒毛膜羊膜炎诊断的特异性和阳性预测值。

Objective To explore the clinical significance in combined detection of C-reactive protein and the cervical secretion smear in chorioamnionitis with preterm premature rupture of membranes （PPROM）. Methods Eighty patients with PPROM（PPROM group） were selected and divided into chorioamnionitis group （n = 55） and without chorioamnionitis（n = 25 ） according to the diagnosis. The levels of C-reactive protein and cervical smear were analysis, including sensitivity, specificity, positive predictive value and negative predictive value. Sixty cases of preterm no premature rupture of membranes pregnant women with the same gestational age were chosed as the control group. Results The positive rate of CRP and cervical secretions smear in PPROM group were higher than those of control group, and the differences were statistically significant （ ~2 = 50. 24, 54. 81 ;P 〈 0. 05 ）. The sensitivity, specificity, positive predictive value and negative predictive value by the CRP diagnosis of chorioamnionitis in patients with PPROM were 58.18%, 63.64%, 36.00%, 32.00% respectively. Those indices of cervical secretions smear diagnosis were 66.67%, 67.31%, 29.03%, 28.57% respectively. The sensitivity, specificity,positive predictive value regarding of CRP and cervical secretions smear joint inspection diagnosis of chorioamnionitis were 69. 09%, 88. 00%, 92. 68%, 56.41% respectively. Conclusion The inspection of CRP combined with cervical secretion smear can improve specificity and positive predictive value of chorioamnionitis diagnosis-with PPROM pregnant women.