血清MMP-2、IL-8、β-hCG对胎膜早破妊娠患者合并羊膜腔感染的诊断

Value of serum matrix metalloproteinase-2,interleukin-8 andβ-human chorionic gonadotropin in diagnosis of amniotic cavity infection in premature rupture of membranes patients

目的探讨血清基质金属蛋白酶-2(Matrix metalloproteinase-2,MMP-2)、白细胞介素-8(interleukin-8,IL-8)、β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)对胎膜早破妊娠患者合并羊膜腔内感染的预测效果。方法选取2017年6月-2018年6月河南省人民医院收治的胎膜早破妊娠患者96例,分为早产胎膜早破组(n=50)及足月胎膜早破组(n=46),另选取足月正常妊娠产妇102名作为对照组,根据病理结果将产妇分娩后分为合并羊膜腔内感染组及非合并羊膜腔内感染组。应用酶联免疫法检测各组血清MMP-2、IL-8、β-hCG水平,应用受试者特异性曲线(ROC)分析血清MMP-2、IL-8、β-hCG在胎膜早破妊娠患者合并羊膜腔内感染中的预测价值。结果足月胎膜早破组及未足月胎膜早破组产前血清MMP-2、IL-8、β-hCG水平均高于对照组(P<0.05),足月胎膜早破与早产胎膜早破组血清MMP-2、IL-8、β-hCG水平比较差异不明显。早产胎膜早破组合并羊膜腔内感染率为60%(30/50)、足月胎膜早破组为34.78(16/46)、对照组为3.92(4/102),三组比较差异有统计学意义(χ^2=58.784,P<0.001)。羊膜腔感染组血清MMP-2、IL-8、β-hCG水平显著高于非合并羊膜腔内感染组(P<0.05)。ROC曲线分析结果,三指标联合应用诊断羊膜腔内感染的灵敏度、特异度分别为0.913、0.920。结论血清MMP-2、IL-8、β-hCG对胎膜早破妊娠产妇羊膜腔内感染有较高的诊断价值,且与产妇预后有密切的关系。

OBJECTIVE To explore the effect of serum matrix metalloproteinase-2(MMP-2),interleukin-8(IL-8)andβ-human chorionic gonadotropin(β-hCG)on prediction of amniotic cavity infection in the premature rupture of membranes(PROM)patients.METHODS A total of 96 patients with premature rupture of membranes who were treated in the People′s Hospital of Henan Province from Jun.2017 to Jun.2018 were enrolled in the study and divided into the preterm PROM group with 50 cases and the full-term PROM group with 46 cases,meanwhile,102 full-term and normal pregnancy puerpera were chosen as the control group.After the delivery,the puerpera were divided into the amniotic cavity infection group and the non-amniotic cavity infection group according to pathological results.The levels of MMP-2,IL-8 andβ-hCG were detected by enzyme-linked immunosorbent assay(ELISA),and the value of the serum MMP-2,IL-8 andβ-hCG in prediction of amniotic cavity infection in the PROM patients was analyzed by means of receiver-operating-characteristic(ROC)curve.RESULTS The levels of serum MMP-2,IL-8 andβ-hCG of the full-term PROM group and the preterm PROM group were significantly higher than those of the control group before the delivery(P<0.05).There were no significant differences in the levels of serum MMP-2,IL-8 andβ-hCG between the full-term PROM group and the preterm PROM group.The incidence rate of amniotic cavity infection was 60%(30/50)in the preterm PROM group,34.78(16/46)in the full-term PROM group,3.92(4/102)in the control group,and there was significant difference among the three groups(χ^2=58.784,P<0.001).The levels of serum MMP-2,IL-8 andβ-hCG of the amniotic cavity infection group were significantly higher than those of the non-amniotic cavity infection group(P<0.05).ROC curve analysis showed that the sensitivity of the joint application of the three indexes was 0.913 in diagnosis of the amniotic cavity infection,the specificity 0.920.CONCLUSION The serum MMP-2,IL-8 andβ-hCG have high values in diagnosis of the amniotic cavity infection in the patients with PROM,which is closely associated with the prognosis of the puerpera.