血清PCT、CRP和白细胞计数对胎膜早破并发绒毛膜羊膜炎的预后评估

Prognostic evaluation of premature rupture of membrane complicated with chorioamnionitis with serum PCT,CRP and WBC

目的检测胎膜早破并发绒毛膜羊膜炎孕妇降钙素原(PCT)、C-反应蛋白(CRP)和白细胞计数水平,为其早期诊断及预后评估提供科学依据。方法选择2014年1月至2015年12月在广西钦州市妇幼保健院治疗的胎膜早破患者100例,其中并发绒毛膜羊膜炎57例,为研究组,43例无并发绒毛膜羊膜炎,为对照组。检测各组PCT、CRP和白细胞计数,评估敏感度和特异度,并进行Logistic回归分析。结果研究组患者血清PCT、CRP和白细胞计数检测结果分别为(11.46±1.13)ng/m L、(13.61±1.08)mg/L和(11.48±1.83)×109/L,均高于对照组的(4.25±0.78)ng/m L、(6.42±0.91)mg/L和(7.65±1.40)×109/L,差异有统计学意义(t值分别为9.89、10.17、9.74,均P<0.05);患者血清PCT、CRP的敏感度和特异度分别为89.47%、88.37%和82.46%、79.09%,均高于白细胞计数的59.65%、67.44%,差异有统计学意义(χ~2值分别为8.78、8.93、8.82、9.11,均P<0.05),且PCT的特异度高于CRP,差异有统计学意义(χ~2=8.05,P<0.05);研究组患者治疗后血清PCT、CRP和白细胞计数检测结果分别为(6.58±1.06)ng/m L、(6.90±0.97)mg/L和(7.11±1.24)×109/L,均低于治疗前,差异有统计学意义(t值分别为9.31、9.60、9.22、均P<0.05)。结论胎膜早破并发绒毛膜羊膜炎患者血清PCT、CRP和白细胞计数均显著升高,血清PCT、CRP敏感度和特异度均高于白细胞计数,有助于胎膜早破并发绒毛膜羊膜炎患者的早期诊断和预后评估。

Objective To detect the levels of procalcitonin（ PCT） and C-reactive protein（ CRP） and white blood cell count（ WBC） of pregnant women with premature rupture of membranes（ PROM） complicated with chorioamnionitis and provide scientific basis for early diagnosis and prognostic evaluation. Methods Totally 100 cases of PROM treated in Guangxi Qinzhou Maternal and Child Health Care Hospital were selected from January 2014 to December 2015,of which 57 cases complicated with chorioamnionitis were set in study group and 43 cases without chorioamnionitis in control group. PCT,CRP and WBC of two groups were detected,and sensitivity and specificity were assessed and Logistic regression analysis was conducted. Results The levels of serum PCT and CRP and WBC of the study group were11. 46 ± 1. 13ng/m L,13. 61 ± 1. 08mg/L and（ 11. 48 ± 1. 83） × 10^9/L,respectively,which were higher than those of the control group[4. 25 ± 0. 78ng/m L,6. 42 ± 0. 91mg/L and（ 7. 65 ± 1. 40） × 10^9/L]. The differences were statistically significant（ t value was 9. 89,10. 17 and 9. 74,respectively,all P 〈0. 05）. The sensitivity of serum PCT and CRP was 89. 47% and 88. 37%,respectively,and the specificity was 82. 46% and 79. 09%,respectively. They were higher than those of WBC（ 59. 65%,67. 44%） with statistical significance（ χ~2value was 8. 78,8. 93,8. 82 and 9. 11,respectively,all P〈 0. 05）. The specificity of PCT was higher than CRP,and the difference was statistically significant（ χ~2= 8. 05,P〈 0. 05）. Serum PCT,CRP and WBC after treatment of the study group were 6. 58 ±1. 06ng/m L,6. 90 ± 0. 97mg/L and（ 7. 11 ± 1. 24） × 109/L,respectively,which were lower than those before treatment with significant differences（ t value was 9. 31,9. 60,and 9. 22,respectively,all P 〈0. 05）. Conclusion Serum PCT,CRP and WBC of PROM patients complicated with chorioamnionitis are significantly elevated. The sensitivity and specificity of serum PCT and CRP are higher than those of WBC,which is helpful for early diagnosis and prognostic evaluation for the patients with PROM complicated with chorioamnionitis.