宫颈分泌物TNF-α和IL-1β联合孕激素对无症状淋球菌感染的诊断价值

Value of combination of cervical secretions TNF-α, IL-1β and serum progesterone in diagnosis of asymptomatic gonococcal infection

目的 探讨宫颈分泌物肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β联合孕激素对无症状淋球菌感染的诊断价值。方法 前瞻性选取2017年1月-2019年12月三亚中心医院和中山大学附属第三医院收治的疑似淋病女性96例。根据淋球菌感染情况和临床症状分为有症状组47例、无症状组33例和健康对照组16名。比较三组宫颈分泌物TNF-α、IL-1β、血清孕激素水平,并分析三者及联合检测对女性无症状淋球菌感染的诊断和鉴别诊断效能。结果 有症状组宫颈分泌物TNF-α、IL-1β高于无症状组和健康对照组(P<0.05);无症状组血清孕激素高于有症状组和健康对照组(P<0.05)。无症状组的宫颈分泌物TNF-α、IL-1β与其血清孕激素呈负相关(P<0.05),宫颈分泌物TNF-α与其宫颈分泌物IL-1β呈正相关(P<0.05)。受试者工作特性曲线(ROC)结果显示,宫颈分泌物TNF-α、IL-1β联合血清孕激素检测可取得较高的女性无症状淋球菌感染诊断价值。结论 血清孕激素和宫颈分泌物TNF-α、IL-1β联合检测对女性无症状淋球菌感染具有较高诊断效能。

OBJECTIVE To explore the value of combination of cervical secretions tumor necrosis factor(TNF)-α, interleukin(IL)-1β and serum progesterone in diagnosis of asymptomatic gonococcal infection. METHODS A total of 96 women with suspected gonorrhea who were treated in Sanya Central Hospital and the Third Hospital Affiliated to Zhongshan University from Jan 2017 to Dec 2019 were prospectively enrolled in the study and were divided into the symptomatic group with 47 cases, the asymptomatic group with 33 cases and the control group with 16 cases according to the status of gonococcal infection and clinical symptoms. The levels of cervical secretions TNF-α, IL-1β and serum progesterone were compared among the three groups. The efficiencies of the three indexes and their joint detection in diagnosis and differential diagnosis of the asymptomatic gonococcal infection were observed. RESULTS The levels of cervical secretions TNF-α and IL-1β of the symptomatic group were significantly higher than those of the asymptomatic group and the control group(P<0.05);the serum progesterone level of the asymptomatic group was significantly higher than that of the symptomatic group and the control group(P<0.05). The cervical secretions TNF-α and IL-1β of the asymptomatic group were negatively correlated with the serum progesterone(P<0.05), and the cervical secretion TNF-α was positively correlated with the cervical secretion IL-1β(P<0.05). Receiver operating characteristic(ROC) curve analysis showed that the combination of cervical secretions TNF-α, IL-1β and serum progesterone had high value in diagnosis of asymptomatic gonococcal infection in women. CONCLUSION The combination of serum progesterone, cervical secretions TNF-α and IL-1β can achieve high efficiency in diagnosis of the asymptomatic gonococcal infection in women.