未足月胎膜早破母体感染患者外周血中HBD-2与PCT和CRP水平变化对HCA诊断的价值研究

Value of peripheral blood HBD-2,PCT and CRP in diagnosis of HCA in patients with preterm premature rupture of membranes maternal infections

目的探讨未足月胎膜早破(PPROM)母体感染外周血中β2防御素(HBD-2)、降钙素原(PCT)、C-反应蛋白(CRP)对于鉴别诊断绒毛膜羊膜炎(HCA)的价值。方法选取2014年1月-2016年1月医院产科就诊的110例PPROM患者,根据产后胎盘组织学检测结果分为HCA组42例、非HCA组68例,另选40例正常体检孕妇作为对照组,对比三组血清HBD-2、PCT、CRP水平,并探讨三类指标诊断HCA的价值。结果 HCA组的血清HBD-2、PCT、CRP水平显著的高于非HCA组、对照组,差异有统计学意义(P<0.05);非HCA组的血清HBD-2、PCT、CRP水平均高于对照组(P<0.05);HCA组的血清HBD-2与PCT及CRP水平呈显著正相关(P<0.05);HBD-2的诊断灵敏度或特异度均>80%,其诊断学价值明显高于单纯CRP或者PCT等指标。结论PPROM母体外周血中HBD-2、PCT、CRP水平升高,HBD-2鉴别诊断PPROM并发HCA的价值高于PCT、CRP。

OBJECTIVE To explore the value of peripheral blood beta 2 defensin（HBD-2）,procalcitonin（PCT）and C-reactive protein（CRP）in differential diagnosis of human chorioamnionitis（HCA）in patients with preterm premature rupture of membranes（PPROM）maternal infections.METHODS A total of 110 PPROM patients who were treated in the obstetrics department from Jan 2014 to Jan 2016 were enrolled in the study and were divided into the HCA group with 42 cases and the non-HCA group with 68 cases according to the results of postpartum placental histology test,while 40 healthy pregnant women who recieved physical examination were chosen as the control group.The levels of serum HBD-2,PCT and CRP were compared among the three groups,and the value of the three types of indexes in diagnosis of HCA was observed.RESULTS The levels of serum HBD-2,PCT and CRP of the HCA group were significantly higher than those of the non-HCA group and the control group（P〈0.05）;the levels of serum HBD-2,PCT and CRP of the non-HCA group were higher than those of the control group（P〈0.05）;the serum HBD-2 of the HCA group was positively correlated with the levels of PCT and CRP（P〈0.05）.The sensitivity and specificity of the HBD-2 were more than 80%in diagnosis of HCA,and the diagnostic value of the HBD-2 was remarkably higher than that of the single CRP or PCT.CONCLUSIONThe levels of peripheral blood HBD-2,PCT and CRP of the patients with PPROM maternal infection are elevated,and the value of the HBD-2 is higher than that of the PCT or CRP in differential diagnosis of the PPROM complicated with HCA.