PCT、CRP、IL-6联合检测对提高早期胎膜早破绒毛膜羊膜炎诊断价值的影响

Effect of combined detection of PCT,CRP,and IL-6 on the diagnostic value of chorioamnionitis in early premature rupture of membranes

目的研究血清降钙素原(PCT)、C-反应蛋白(CRP)、白介素(IL-6)联合检测对提高早期胎膜早破(PROM)绒毛膜羊膜炎(CAM)诊断价值的影响。方法选取2016年1月至2017年6月浙江省乐清市人民医院妇产科住院分娩的100例胎膜早破孕妇作为研究对象。将这100例孕妇设为观察组,随机选择同期住院分娩的100例正常孕妇作为对照组。分娩前,分别测定两组产妇的各项血清学指标水平,并对检测结果进行比较,于观察组孕妇成功分娩后,将胎盘送至病理检查,根据病理报告将其分为绒毛膜羊膜炎组(n=68)和非绒毛膜羊膜炎组(n=32),比较两组患者上述血清学指标水平,同时计算上述单项指标及联合指标对应的特异性、灵敏性,在此基础上,计算各项检测相应的阳性检测值及阴性检测值。结果观察组孕妇血清中PCT、CRP、IL-6的水平均高于对照组孕妇,差异具有统计学意义(P<0.05);绒毛膜羊膜炎组孕妇的PCT、CRP、IL-6的水平均高于非绒毛膜羊膜炎组孕妇,差异具有统计学意义(P<0.05);三组孕妇联合检测的特异性、灵敏性、阳性预测值及阴性预测值均高于单项检查,差异具有统计学意义(P<0.05)。结论在诊断早期胎膜早破绒毛膜羊膜炎中,PCT、CRP、IL-6等单项指标均表现出了一定价值,但单项检测均存在着不同程度的缺陷,而PCT、CRP、IL-6联合检测可显著提升早期胎膜早破绒毛膜羊膜炎的诊断价值,对改善母婴的分娩结局及预后情况也有着积极意义。

Objective To study the effect of combined detection of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin(IL-6)on the diagnosis of chorioamnionitis(CAM)in early premature rupture of membranes(PROM).Methods From January 2016 to June 2017,100 pregnant women with PROM were selected as observation group,and 100 normal pregnant women were randomly selected as control group.The serological indexes of the two groups were measured,and the results were compared.Placentas of observation group were sent for pathological examination and the observation group were further divided into CAM group(n=68)and non-CAM group(n=32)according to the pathological report.At the same time,the specificity and sensitivity of single indexes and combined indexes were calculated.On this basis,the corresponding positive and negative detection values were calculated.Results The serum levels of PCT,CRP and IL-6 in the observation group were higher than those in the control group(P<0.05),and the levels of PCT,CRP and IL-6 in the CAM group were higher than those in the non-CAM group(P<0.05).The specificity,sensitivity,positive predictive value and negative predictive value of combined detection were higher than those of single detection(P<0.05).Conclusions In the diagnosis of CAM in early PROM,PCT,CRP,IL-6 and other single indexes all have some value and some defects.The combined detection of PCT,CRP and IL-6 can significantly improve the diagnostic value of CAM in early PROM and improve the delivery outcome and prognosis of mothers and infants.