血清IL-6,IL-8与宫颈sIgA联合检测对女性慢性盆腔炎的诊断价值研究

Diagnostic value of combined detection of serum IL-6,IL-8 and cervical sIgA in female chronic pelvic inflammatory disease

目的探究血清白介素(interleukin,IL)-6、IL-8与宫颈分泌型免疫球蛋白A(secretory immunoglobulin A,sIgA)联合检测对女性慢性盆腔炎的诊断价值。方法收取2014年5月—2017年12月在鄂州市中心医院经腹腔镜确诊为慢性盆腔炎的女性患者130例为病例组,与同期在该院行体检的健康女性150例为对照组,比较2组女性的血清IL-6、IL-8与宫颈sIgA水平,分析3者表达水平与慢性盆腔炎患者临床病例特征之间的关系。采用受试者工作特征曲线(receiver operating characteristic,ROC)分析血清IL-6、IL-8与宫颈sIgA对女性慢性盆腔炎的诊断价值,多元Logistic回归计算3者预测女性慢性盆腔炎发病的风险比(oddsratio,OR)及95%置信区间(confidence interval,CI)。结果与对照组比较,病例组女性的血清IL-6、IL-8与宫颈sIgA水平升高,差异比较具有统计学意义(t=3.967,P=0.003;t=4.013,P<0.001;t=2.986,P=0.002)。血清IL-6、IL-8在输卵管炎中增高最为显著,而宫颈sIgA在子宫体炎中增高最为显著。ROC结果表明,血清IL-6、IL-8与宫颈sIgA鉴别诊断女性慢性盆腔炎的灵敏度/特异性分别为84.9%/73.7%、77.5%/81.3%和38.9%/92.3%;诊断界值分别为:94.6pg/mL、88.6pg/mL和70.2μg/mL;联合3项指标的灵敏度为82.8%,特异度为93.6%。多元Logistic回归分析表明,高IL-6、IL-8、sIgA水平均是女性慢性盆腔炎发病的独立危险因素。结论联合血清IL-6,IL-8与宫颈sIgA3项指标可协助女性慢性盆腔炎的诊断,同时,3者对女性慢性盆腔炎发病风险的预测也具有潜在价值。

Objective To explore the diagnostic value of serum interleukin-6 (IL-6), IL-8 and cervical secretory immunoglobulin A (sIgA) in women with chronic pelvic inflammatory disease. Methods From May 2014 to December 2017, 130 women with laparoscopic diagnosis of chronic pelvic inflammatory disease in Ezhou Central Hospital were selected as case group and 150 healthy women as control group. The levels of serum IL-6, IL-8 and cervical sIgA were compared between the two groups. The relationships between the expression level of IL-6, IL-8, cervical sIgA and the clinicopathological characteristics of chronic pelvic inflammatory disease patients were analyzed. The diagnostic value of serum IL-6, IL-8 and cervical sIgA for chronic pelvic inflammatory disease was analyzed by receiver operating characteristic (ROC), and the odds ratio (OR) and 95% confidence interval (CI) were calculated by multiple logistic regression. Results Compared with the control group, the levels of serum IL-6, IL-8 and cervical sIgA were significantly higher in the case group ( t =3.967, P =0.003;t =4.013, P <0.001;t =2.986, P =0.002 respectively). Serum IL-6 and IL-8 were most significantly increased in salpingitis, while cervical sIgA was most significantly increased in uterine stomatitis. ROC results showed that the sensitivity/specificity of serum IL-6, IL-8 and cervical sIgA to differentiate chronic pelvic inflammatory disease from healthy women were 84.9%/73.7%、77.5%/81.3% and 38.9%/92.3%, respectively. The diagnostic values were 94.6 pg/mL, 88.6 pg/mL and 70.2 μg/mL, respectively. The sensitivity/specificity of combined three indices were 82.8% and 93.6%, respectively. Multiple logistic regression analysis showed that high levels of IL-6, IL-8 and sIgA were all independent risk factors for chronic pelvic inflammatory disease. Conclusion Combined detection of serum IL-6, IL-8 and cervical sIgA may be helpful in the diagnosis of chronic pelvic inflammatory disease, and they also have potential value in predicting the risk of chronic pelvic inflammatory disease.