联合检测IL-6、CRP及D-二聚体预测早期先兆流产结局的应用

Combined detection of IL-6,CRP and D-dimerto in early threatened abortion and fetal outcome preservation

目的:探讨检测白细胞介素-6(IL-6)、C-反应蛋白(CRP)及D-二聚体在预测早期先兆流产保胎结局的应用价值。方法:选取医院收治的早期先兆流产患者97例为先兆流产组,其中65例保胎成功,32例发生难免流产;正常妊娠50例设为对照组。两组孕妇入院时均联合检测血浆IL-6、CRP及D一二聚体三项指标,综合评估妊娠结局。结果:正常妊姬组IL-6、CRP及D-二聚体值均小于先兆流产组,且保胎成功组低于难免流产组,差异均有统计学意义(P<0.05)。当IL-6、CRP及D-二聚体的截断值分别为8.45 μg/mL、15.24μg/L、0.86 mg/L时,预测难免流产发生风险的ROC曲线下面积分别为0.72.0.66.0.67。二元Logistic回归分析研究显示,IL-6、CRP及D-二聚体均是难免流产患者的独立风险因素,对预测保胎结局有统计学意义(P<0.05)。血浆IL-6、CRP及D-二聚体单独判断先兆流产预后的准确率分别为85.57%82.47%.8144%,三项联合判定先兆流产预后的准确率为92.78%,显著高于单项判断,差异有统计学意义(P<0.05)。结论:IL-6、CRP及D-二聚体均对早期先兆流产的保胎结局有预测价值,L--6的灵敏度最高,且联合检测对是否发生难免流产的预测价值明显高于单独检测。

Objective:To explore the application value of detecting interleukin-6(IL-6),CRP(C-reactive protein)and D-dimer in early threatened abortion and fetal outcome preservation.Methods:to select the hospital in hefei of 97 cases of threatened abortion patients admitted in January as threatened abortion group,65 cases spue successful,32 cases of inevitable abortion,50 cases as control group,normal pregnancy testing all into the group of pregnant women on the plasma IL-6,CRP and D-dimer and as a result,the comprehensive evaluation of combined detection of clinical guidance value in diagnosis and treatment of threatened abortion.Results:TL-6,CRP and D-dimer in the normal pregnancy group were lower than those in the threatened abortion group,and IL-6,CRP and D-dimer in the successful pregnancy group were lower than those in the inevitable abortion group,the differences were statistically significant(P<0.05).When the cut-off values of IL-6,CRP and D-dimer were 8.45pg/mL,15.24 g/L and 0.86mg/L,respectively,the areas under the ROC curve for predicting the risk of inevitable abortion were 0.72,0.66 and 0.67,respectively.Binary Logistic regression analysis showed that IL-6,CRP and D-dimer were all independent risk factors for patients with inevitable abortion,which had statistical significance in predicting fetal outcome(P<0.05).The prognosis accuracy of plasma IL-6,CRP and D-dimer alone was 85.57%,82.47%and 81.44%,respectively.The prognosis accuracy of the combination of plasma IL-6,CRP and D-dimer was 92.78%,which was significantly higher than that of the separate judgment,and the difference was statistically significant(P<0.05).Conclusion:TL—6,CRP and D-dimer all have predictive value for the fetal outcome of early threatened abortion,and IL-6 has the highest sensitivity,and the predictive value of combined detection for the occurrence of inevitable abortion is significantly higher than that of single detection.