血清ICAM-1、IL-6检测联合免疫荧光染色检查对PPROM合并羊膜腔感染的预测意义

Significance of serum ICAM-1 and IL-6 detection combined with immunofluorescence staining in prediction of amniotic cavity infection with PPROM

目的探讨血清细胞间黏附分子-1(ICAM-1)、白介素-6(IL-6)检测联合阴道分泌物免疫荧光染色对未足月胎膜早破(PPROM)合并羊膜腔感染预测的意义。方法选择陕西省榆林市第一医院于2016年2月到2017年2月期间收治的60例PPROM患者,作为观察组,选择同期入院的正常孕妇60例,作为对照组。监测观察组患者入院后破膜6h以内、分娩时,对照组入院后、分娩时的血清ICAM-1、IL-6水平以及阴道分泌物免疫荧光染色结果。观察组患者在分娩后对胎盘胎膜进行病理检查,确定孕妇是否出现羊膜腔感染。结果观察组患者的ICAM-1、IL-6水平显著高于对照组,差异显著(t值分别为10.346、10.595,P>0.05),观察组免疫荧光染色阳性率较对照组更高,差异显著(χ~2=43.621,P<0.05)。在观察组中,羊膜腔感染者的ICAM-1、IL-6水平显著高于非感染者(t值分别为8.888、7.759,均P<0.05),羊膜腔感染者的免疫荧光染色阳性率明显高于非感染者,差异显著(χ~2=21.430,P<0.05)。观察组患者的免疫荧光染色阴道感染情况较对照组更加严重,对比后差异有统计学意义(u=7.864,P<0.05)。血清ICAM-1、IL-6检测、阴道分泌物免疫荧光染色单独检测预测PPROM合并羊膜腔感染的特异性、阳性、阳性预测率及阴性预测率对比后差异无统计学意义(均P>0.05),联合检测预测PPROM合并羊膜腔感染的特异性、阳性预测值和阴性预测值均高于单一指标,差异显著(χ~2值分别为6.340、8.290、4.480,均P<0.05),而敏感性与单一指标相比差异不显著(均P>0.05)。结论血清ICAM-1、IL-6检测联合阴道分泌物免疫荧光染色对PPROM合并羊膜腔感染预测的敏感性、特异性均较高,且可用于诊断PPRPOM合并羊膜腔感染,指导临床治疗。

Objective To observe the significance of serum intercellular adhesion molecule-1（ICAM-1）and interleukin-6（IL-6）detection combined with immunofluorescence staining in the prediction of amniotic cavity infection with preterm premature rupture of membrane（PPROM）.Methods Sixty cases of PPROM admitted in Yulin First Hospital from February 2016 to February 2017 were selected as observation group,and 60 normal pregnant women hospitalized at the same period were selected as control group.Serum ICAM-1,IL-6 levels within 6 hours after membrane rupture and during childbirth in observation group and serum ICAM-1,IL-6 levels after admission and during childbirth in control group and immunofluorescence staining results were measured.Placenta and membrane of patients in observation group were examined to detect amniotic cavity infectionn.Results ICAM-1 and IL-6 levels in observation group were significantly higher than those in control group and differences were significant（t value was10.346,10.595 respectively,both P〈0.05）.Positive rate of immunofluorescence staining in observation group was higher than that in control group and difference was significant（χ~2=43.621,P〈0.05）.In observation group,levels of ICAM-1 and IL-6 in amniotic cavity infection cases were significantly higher than those in non-infected patients（t value was 8.888,7.759 respectively,both P〈0.05）,and positive rate of immunofluorescence staining in amniotic cavity infection cases was higher than non–infected cases,and difference was significant（χ~2=21.430,P〈0.05）.Vaginal infection detected by immunofluorescence staining in observation group was more severe than that in control group,and difference had statistical significance（u=7.864,P〈0.05）.There were no significant differences in specificity,positive predictive value and negative predictive value in serum ICAM-1,IL-6 detection,and immunofluorescence staining alone in prediction of PPROM with amniotic cavity infection（all P〈0.05）.Specificity,positive predictive value,and negative predictive value of combined detection in prediction of PPROM with amniotic cavity infection were higher than those of single index detection,and differences were significant（χ~2 value was 6.340,8.290,and4.480 respectively,all P〈0.05）.There was no significant difference in sensitivity of combined detection and single index detection（P〈0.05）.Conclusion The sensitivity and specificity of serum ICAM-1 and IL-6 detection combined with immunofluorescence staining are higher for predicting PPROM with amniotic cavity infection.It can be used to detect PPROM with amniotic cavity infection and guide clinical treatment.