自发性早产孕妇孕晚期血浆中P-LAP与IL-6水平的变化分析

Analysis of plasma P-LAP and IL-6 levels in spontaneous preterm pregnant women in the third trimester

目的分析自发性早产孕妇孕晚期血浆中胎盘亮氨酸氨肽酶(P-LAP)与白介素-6(IL-6)水平的变化。方法选取四川大学华西第二医院收治的126例自发性早产孕妇作为自发性早产组,同期选取本院126例健康足月分娩产妇作为对照组,均于孕晚期对其进行血浆中P-LAP与IL-6水平检测,观察检测结果,分析血浆中P-LAP与IL-6水平变化在自发性早产孕妇中的意义。结果与对照组相比,自发性早产组28~32周、33~37周血浆P-LAP水平更低、IL-6水平更高,差异有统计学意义(P<0.05);自发性早产组33~37周P-LAP水平、IL-6水平与28~32周组间比较差异有统计学意义(P<0.05);与不伴SC自发性早产组28~32周、33~37周相比,伴有绒毛羊膜炎(SC)自发性早产组P-LAP水平更低,IL-6水平更高,差异有统计学意义(P<0.05);经Pearson相关性检验结果分析发现,自发性早产孕妇血浆P-LAP与IL-6呈负相关(r=-0.312,P<0.05);经分析发现,P-LAP检测发现98例存在异常,IL-6检测发现97例存在异常,联合检测发现122例存在异常,联合检测异常发现人数更多;联合检测诊断敏感度(96.83%)、特异度(94.44%)、准确度(95.63%)显著高于单项检查结果,差异有统计学意义(P<0.05)。结论对自发性早产孕妇孕晚期加强P-LAP与IL-6水平联合检测,对预测早产有积极作用,有助于临床医师依据检测结果及时施以针对性方案干预,保障孕妇足月生产,提升母婴生存质量。

Objective To analyze the changes of plasma P-LAP(placental leucine aminopeptidase)and IL-6(interleukin-6)levels in spontaneous preterm pregnant women in the third trimester of pregnancy.Methods 126 cases of spontaneous preterm pregnant women from west China Second Hospital,Sichuan University were selected as spontaneous preterm group and at the same time selection in the hospital 126 cases of healthy full term pregnant women as control group.The plasma P-LAP and IL-6 level were detected and analyzed.Results Compared with the control group,the levels of plasma P-LAP and IL-6 were lower and higher in the spontaneous preterm group at 28-32 weeks and 33-37 weeks,the differences were statistically significant(P<0.01).The levels of P-LAP and IL-6 in the spontaneous preterm group at 33-37 weeks and 28-32 weeks were statistically significant(P<0.01).Compared with the group without SC spontaneous preterm delivery at 28-32 weeks and 33-37 weeks,the P-LAP level was lower and the IL-6 level was higher in the group with SC spontaneous preterm delivery,and the difference was statistically significant(P<0.01).The results of Pearson correlation test showed that plasma P-LAP was negatively correlated with IL-6(r=-0.312,P<0.01)in spontaneous preterm delivery women.After analysis,98 cases were found abnormal by P-LAP test,97 cases were found abnormal by IL-6 test,122 cases were found abnormal by combined test,and more people were found abnormal by combined test.The sensitivity,specificity and accuracy of the combined test were significantly higher than those of the single test,and the difference was statistically significant(P<0.01).Conclusion To strengthen the joint detection of P-LAP and IL-6 level in spontaneous preterm delivery of pregnant women in the late trimester has a positive effect on the prediction of preterm delivery,and is helpful for clinicians to timely implement targeted program intervention according to the test results,ensure the pregnant women to deliver at term,and improve the quality of life of mothers and infants.