未足月胎膜早破并发绒毛膜羊膜炎的临床诊断指标的价值研究

The Value of Clinical Diagnostic Index of Premature Rupture of Fetal Membranes with Chorioamnionitis

目的:探讨急性绒毛膜羊膜炎诊断指标在体温正常的未足月胎膜早破并发绒毛膜羊膜炎中的诊断价值。方法:回顾性分析笔者所在医院2017年1-12月体温正常的未足月胎膜早破病例,绒毛膜羊膜炎组158例,无绒毛膜羊膜炎组218例,统计分析入院时外周血CRP、WBC等临床资料。结果:两组病例母亲年龄、破膜孕周、入院体温、胎位及不良生育史等一般资料差异无统计学意义(P>0.05)。两组病例C反应蛋白(CRP)、白细胞计数(WBC)差异有统计学意义(P=0.009、0.001),利用CRP、WBC联合体温绘制ROC曲线,三项联合的曲线下面积AUC=0.624。结论:白细胞计数及CRP对于体温正常的未足月胎膜早破并发绒毛膜羊膜炎具有一定早期诊断价值,但诊断效能不高,其余临床指标单一使用不具有诊断价值,需要进一步研究诊断指标。

ObjectiveTo investigate the diagnostic value of acute chorioamnionitis in patients with normal body temperature and premature rupture of fetal membranes.Method： Retrospective analysis was performed on the cases of premature rupture of fetal membranes with normal body temperature from January to December 2017 in our hospital,including 158 cases in the chorioamnionitis group and 218 cases in the non-chorioamnionitis group.White blood cell count and CRP were analyzed.Result：There were no statistically significant differences between the two groups in general data such as maternal age,gestational rupture,admission temperature,placental position,and adverse birth history（P〉0.05）. There were statistically significant differences in c-reactive protein（CRP） and WBC count（P=0.009 and P=0.001） between the two groups.ROC curve was plotted by using CRP and WBC combined with body temperature.AUC of the three combined curves was 0.624.Conclusion：White blood cell count and CRP are of certain early diagnostic value for the premature rupture of fetal membranes and chorioamnionitis with normal body temperature,but the diagnostic efficiency is not high.The single use of other clinical indicators does not have diagnostic value,which requires further study of diagnostic indicators.