血清降钙素原联合白细胞介素-8检测在预测未足月胎膜早破合并绒毛膜羊膜炎中的应用价值

The application value of serum procalcitonin combined with interleukin-8 in predicting preterm premature rupture of membranes combined with chorioamnionitis

目的研究分析血清降钙素原(procalcitonin,PCT)联合白细胞介素-8(interleukin-8,IL-8)在预测未足月胎膜早破合并绒毛羊膜炎的应用价值。方法选取深圳市宝安区沙井人民医院2014年1月至2015年1月收治的未足月胎膜早破患者80例为研究组(其中合并绒毛膜羊膜炎60例为研究A组,未合并者20例为研究B组),同期足月胎膜早破产妇40例为对照C组,同期孕周相同的健康产妇40例为对照D组,测定并比较4组血清PCT、IL-8的浓度及阳性率,评价单一标志物检测及联合检测对绒毛膜羊膜炎的诊断价值。结果研究A组的PCT、IL-8浓度以及阳性率显著高于研究B组、对照C组和对照D组,差异有统计学意义(P<0.05);研究B组和对照C组的PCT、IL-8浓度以及阳性率也高于对照D组,差异有统计学意义(P<0.05)。PCT和IL-8对诊断绒毛膜羊膜炎的敏感性均较高(83.3%、90%),但特异性均较低(70%、65%),且误诊率均较高(30.0%、35.0%),但PCT联合IL-8检测的敏感性和特异性均较高(83.3%、90.0%),经一致性检验,其K值为0.763,表明联合检测结果与病理检查的一致性极好。结论相较于单一指标,血清PCT联合IL-8能大大提高预测未足月胎膜早破合并绒毛膜羊膜炎的准确性和可靠性。

Objective To study the application value of serum procalcitonin （PCT） combined with interleukin -8 （IL -8 ） in prediction of preterm premature rupture of membranes combined with ehorioamnionitis. Methods 80 cases with preterm premature rupture of membranes in Sharing People＆ Hospital of Bao＇ an District from Jan 2014 to Jan 2015 were selected as study group （those combined with chorioamnionitis were put into study group A, and others were in study group B ）. 40 cases of full - term premature rupture of membranes were selected as the control group C, and 40 cases of healthy maternal were selected as the control group D. The serum PCT, IL - 8 concentration and positive rate were compared among 4 groups, and single symbol detection and combined detection of chorioamnionitis were evaluated also. Results There were 60 cases in study group A and 20 cases in study group B by pathological examination. The serum PCT, IL - 8 concentration and positive rate in study group A were higher than those in study group B, control group C and D, and there were significant differences （ P 〈 0. 05 ）. The serum PCT, IL - 8 concentration and positive rate in study group B and control group C were higher than those in control group D, and there were significant differences （ P 〈 0.05 ）. The sensitivity of PCT and IL -8 in diagnosis of ehorioamnionitis were high （83.3%, 90% ）, but the speeifieies were low （70%, 65 % ）, and misdiagnosis rates were also high （ 30. 0%, 35.0% ）. But the detection sensitivity and specificity of PCT and IL - 8 were both high （83.3%, 90.0% ） , and weighted kappa [ K4（w） ] statistic showed that combined test results and pathological examination had excellent consistency （ K = 0. 763 ）. Conclusion Serum PCT combined with IL8 could greatly improve the accuracy and reliability of diagnosis in prediction of preterm premature rupture of membranes combined with chorioamnionitis.