ICAM-1和PCT与未足月胎膜早破并发绒毛膜羊膜炎的相关性研究

A study on correlation of ICAM-1 and PCT with preterm premature rupture of membranes complicated with chorioamnionitis

目的分析细胞间黏附分子-1(ICAM-1)和降钙素原(PCT)与未足月胎膜早破(p-PROM)合并绒毛膜羊膜炎(CA)的关系及其对疾病的诊断效能。方法选择48例单纯p-PROM患者(P组)、37例p-PROM并发CA患者(C组)及30例足月正常分娩的孕妇(对照组)为研究对象。P组和C组在入院确诊后、对照组在正常产检或待产时,采用ELISE法分别检测各组血清可溶性ICAM-1(sICAM-1)和PCT水平,采用免疫组化SP法检测胎膜组织ICAM-1的表达水平。比较各组检测结果,并绘制ROC曲线,以曲线下面积判断血清sICAM-1和PCT对p-PROM并发CA患者的诊断敏感度和特异度。结果 P组血清PCT、sICAM-1及胎膜ICAM-1的表达水平明显高于对照组(P<0.05),C组血清sICAM-1及胎膜ICAM-1的表达水平明显高于P组(P<0.05)。p-PROM并发CA重度组的血清PCT、sICAM-1及胎膜ICAM-1的表达水平明显高于p-PROM并发CA轻中度组(P<0.05)。当血清PCT截断点为70.36 pg/ml时,PCT对p-PROM并发CA的诊断敏感度、特异度分别为69.8%、55.4%;当血清sICAM-1截断点为959.41 ng/ml时,血清sICAM-1对p-PROM并发CA患者的诊断敏感度、特异度分别为89.6%、79.1%。结论血清sICAM-1和PCT与p-PROM并发CA有关,且血清sICAM-1对CA的诊断效能高于PCT。

Objec t ive To anatyze the relationship between the intercellular adhesion molecule-1 （ICAM-1） and procalcitonin （PCT） and the preter^n premature rupture of membranes （p-PROM） complicated with chorioamnionitis （CA） and their diagnostic efficiency’ in predicting diseases. MeAods 48 patients with simple p-PROM （＂ group P＂ ） ,3 7 patients with p-PROM complicated withCA（＂ group C＂ ）and 30 women who had full-term normal delivery（＂ control group＂ ）were selected for this study. The ELISE method was used to measure the serum levels of soluble ICAM-1 （sICAM-1） and PCT, and the SP method in immunohistochemistry was used to measure the expression level of ICAM-1 in fetal membranes in groups P and C after the diagnosis and in the control group during normal prenatal care or before birth. The results were compared among the groups; the receiver operating characteristic （ROC） curves were plotted respectively and the areas under the curves were used to determine the diagnostic sensitivity and specificity of serum sICAM-1 and PCT on patients with p-PROM complicated with CA. R＇ults The expression levels of serum PCT, sICAM-1 and ICAM-1 in group P were significantly higher than those in the control group （P 〈 0.05）, and the expression levels of serum sICAM-1 and ICAM-1 in fetal membranes in group C were significantly higher than those in group P （P〈 0.05）. The expression levels of serum PCT, sICAM-1 and ICAM-1 in the group with p-PROM complicated with severe CA were significantly higher than those in the group with p-PROM complicated with mild and moderate CA （P 〈 0.05）. When the cut-off point of serum PCT was 70.36 pg/ml, the diagnostic sensitivity and specificity of serum PCT to p-PRAOM complicated with CA in the patients were 69.8% and 55.4% , respectively. When the cut-off point of serum sICAM-1 was 959.41 ng/ml, the diagnostic sensitivity and specificity of serum sICAM-1 to p-PRAOM complicated with CA in the patients were 89.6% and 79.1% respectively. C on clusion The serum sICAM-1 and PCT areassociated with the p-PROM complicated with CA, and serum sICAM-1 has better diagnostic efficiency than PCT in predicting CA.