羊水炎症因子对宫颈机能不全妇女母婴结局的预测效果

Predictive efficacyvalues of amniotic fluid inflammatory cytokines in maternal and fetal prognosis in women with cervical incompetence

目的探索羊水炎症因子对宫颈机能不全妇女母婴结局的预测效果。方法选取2015年1月~2018年9月于我院接受治疗的72例宫颈机能不全并行紧急子宫颈环扎术的孕妇为研究对象,按照妊娠结局将患者分为活婴组(50例)和死婴组(22例)。比较两组孕妇的炎性因子水平和围术期情况,判断炎性因子对妊娠结局的预测价值。结果活婴组的白细胞介素-8(8.24±0.69)mg/L、肿瘤坏死因子α水平(1.44±0.31)ng/mL,显著低于死婴组(P<0.05)。活婴组的分娩孕周(31.69±3.57)周、妊娠延长时间(6.02±1.84)周,显著高于死婴组(P<0.05)。白细胞介素-8的灵敏度为92.35%,特异性为62.68%,肿瘤坏死因子α的灵敏度为78.29%,特异性为83.35%,具有较好的预测价值。结论子宫颈环扎术前的外周血白细胞计数、白细胞介素-8以及肿瘤坏死因子α是影响宫颈机能不全孕妇妊娠结局的重要因素,且白细胞介素-8和肿瘤坏死因子α对于围产儿死亡具有重要预测价值,对于指导临床工作具有重要意义。

Objective To investigate the predictive efficacy of amniotic fluid inflammatory cytokines in maternal and fetal prognosis in women with cervical incompetence.Methods Seventy-two pregnant women with cervical incompetence who immediately underwent Shirodkar’s operation at our hospital from January 2015 to September 2018 were selected as research subjects.They were divided into the living infant group(n=50)and the dead infant group(n=22)according the pregnancy outcome.Amniotic fluid inflammatory cytokine levels and clinical manifestations during the perioperative period were compared between the two groups.The predictive value of inflammatory cytokines in the pregnancy outcome was evaluated.Results The levels of interleukin(IL)-8 and tumor necrosis factor-α(TNF-α)were(8.24±0.69)mg/L and(1.44±0.31)ng/mL in the living infant group,which were lower than those in the dead infant group(P<0.05).The gestational weeks and longer prolongation of gestation time were(31.69±3.57)weeks and(6.02±1.84)in the living infant group,which were longer than those in the dead infant group(P<0.05).The sensitivity of IL-8 and TNF-αwas 92.35%and 78.29%,and the specificity of two indices was 62.68%and 83.35%respectively,showing favorable predictive efficacy.Conclusion White blood cell count,IL-8 and TNF-αbefore Shirodkar’s operationare key factors affecting the pregnancy outcome of pregnant women with cervical incompetence.Besides,IL-8 and TNF-αexhibit significant values in predicting infant mortality during the perioperative period,which is critical for guiding clinical practices.