降钙素原、C-反应蛋白检测在胎膜早破宫内感染诊疗中的价值

Value of procalcitonin and CRP detection in diagnosis and treatment of premature rupture of fetal membranes and intrauterine infections

目的探讨降钙素原（PCT）、C-反应蛋白（CRP）检测在胎膜早破宫内感染诊疗中的价值。方法选择福建省妇幼保健院产科2015年1-12月收治的20名剖宫产分娩的足月胎膜早破孕妇作为观察组，选取20名剖宫产分娩的正常足月孕妇作为对照组，采集两组空腹静脉血3m1进行检测，并在胎盘娩出后取胎膜组织进行病理组织学检查：采用免疫色谱检测法检测PCT水平，采用散射比浊法测定血清CRP。结果①观察组中共发现绒毛膜羊膜炎15例，发病率为75％；对照组中共发现绒毛膜羊膜炎5例，发病率为25％；观察组绒毛膜羊膜炎发病率明显高于对照组，差异有统计学意义（P〈0．05）。②观察组孕妇的血清PCT、CRP水平均明显高于对照组，差异有统计学意义（P〈0．05）。两组的PCT与CRP水平之间无明显相关性（P〉0．05）。结论血清PCT联合CRP检测在胎膜早破宫内感染临床诊疗中的准确性较高，可以作为绒毛膜羊膜炎的重要检测指标，具有重要的指导意义。

Objective To investigate the effectiveness of application of procalcitonin （PCT） and C-reactive protein （CRP） in the diagnosis and treatment of premature rupture of fetal membranes （PROM） and intrauterine infections. Methods Altogether 20 pregnant women who underwent cesarean delivery with premature rupture of membranes in the Department of Obstetrics in Maternity and Child Care Center of Fujian Province from January to December 2015 were taken as observation group;20 normal pregnant women who accepted cesarean section were selected as control group.3 ml of fasting venous blood were collected and detected from two groups;and pathological examinations of fetal tissuestaken after delivery of the placenta were made.Serum PCT and CRP level were measured by using nephelometry and immune chromatography method respectively.Results ①Among patients in observation group,15 cases of chorioamnionitis were found and the incidence rate was 75% ;while, among control group,chorioamnionitis were found in 5 cases with the incidence rate accounting for 25%.Chorioamnionitis of observation group was significantly higher than that of control group,with statistical significance（P〈0.05）.②The levels of serum CRP and PCT of observation group were significantly higher than those of control group,with statistical significance （P〈0.05）.There was no significant correlation between the levels of CRP and PCT in the two groups （P〉0.05）.Conclusion Combination of application of serum CRP and PCT detection demonstrates high accuracyin the clinical diagnosis and treatment of premature rupture of fetal membranes and intrauterine infections,which can be used as an important indicator of the detection of chorionic villi and has great guidance significance.