超声下胎膜厚度结合血清炎症因子对早产的预测价值

Predictive Value of Fetal Membrane Thickness Combined with Serum Inflammatory Factors Under Ultrasound in Preterm Delivery

目的探讨超声下胎膜厚度结合血清炎症因子预测早产的价值。方法选取2019年8月至2021年1月广东省人民医院南海医院收治的600例孕妇为研究对象,根据分娩情况分为早产组(≥28周但<37周分娩,n=173)和足月组(≥37周分娩,n=427),两组均于孕24、32周接受超声颈透明层技术测量胎膜厚度,并检测血清炎症因子指标[白细胞介素6(IL-6)、C反应蛋白(CRP)],比较两组基线资料、孕24、32周胎膜厚度、血清IL-6、CRP水平,并比较孕24、32周不同血清IL-6、CRP水平的胎膜厚度,分析胎膜厚度与血清IL-6、CRP的相关性,探讨早产发生的影响因素,评价孕24、32周胎膜厚度、血清IL-6、CRP水平对早产的预测价值。结果孕24、32周,早产组胎膜厚度、血清IL-6、CRP水平高于足月组(P<0.05);孕24、32周血清IL-6、CRP水平与胎膜厚度呈正相关(P<0.05)。将职业、妊娠期高血压控制后,孕24、32周胎膜厚度、血清IL-6、CRP仍与早产相关(P<0.05);孕24、32周胎膜厚度联合血清IL-6、CRP预测早产的AUC均有一定预测价值,且孕32周预测价值更高。结论血清IL-6、CRP与超声下胎膜厚度均存在正相关性,三者联合有助于提高早产预测价值,可作为一种新的预测早产方法,指导临床开展合理有效的防治。

Objective To investigate the value of fetal membrane thickness combined with serum inflammatory factors under ultrasound in predicting preterm delivery.Methods A total of 600 pregnant women who were admitted to Nanhai Hospital of Guangdong Provincial People’s Hospital from August 2019 to January 2021 were selected as the research objects.According to the delivery status,they were divided into preterm delivery group(≥28 weeks but<37 weeks delivery,n=173)and term group(≥37 weeks of delivery,n=427).Both groups received ultrasound cervical hyaline technique to measure the thickness of fetal membranes at 24 and 32 weeks of gestation,and the serum inflammatory factors were detected[interleukin 6(IL-6),C-reactive protein(CRP)],and the baseline data,fetal membrane thickness,serum IL-6 and CRP levels at 24 and 32 weeks of gestation were compared between the two groups,and the expression of different serum IL-6 and CRP levels at 24 and 32 weeks of gestation fetal membrane thickness were compared,and the correlation between fetal membrane thickness and serum IL-6 and CRP were analyzed.The influencing factors of preterm birth were explored,and the predictive value of fetal membrane thickness,serum IL-6 and CRP levels at 24 and 32 weeks of gestation were evaluated.Results At 24 and 32 weeks of gestation,the fetal membrane thickness,serum IL-6 and CRP in the preterm group were higher than those in the term group(P<0.05),and the serum IL-6,CRP levels were positively correlated with the fetal membrane thickness at 24 and 32 weeks of gestation(P<0.05).After the occupational and pregnancy-induced hypertension were controlled,the fetal membranes thickness,serum IL-6 and CRP were still related to preterm delivery at 24 and 32 weeks of gestation(P<0.05).The predictive value of AUC of preterm delivery at 24 and 32 weeks of fetal membrane thickness combined with serum IL-6 and CRP has certain predictive value,and the predictive value of 32 weeks of gestation is higher.Conclusion There is a positive correlation between serum IL-6,CRP and the thickness of fetal membranes under ultrasound.The combination of the three can help improve the predictive value of preterm delivery.It can be used as a new method to predict preterm delivery and guide the clinical development of reasonable and effective prevention and treatment measures.