血清人绒毛膜促性腺激素和降钙素原及中性粒细胞淋巴细胞比值诊断未足月胎膜早破宫内感染的临床意义

Clinical significance of serumβ-human chorionic gonadotropin,procalcitonin and neutrophil-lymphocyte ratio in diagnosis of intrauterine infection with preterm premature rupture of membranes

目的探讨血清人绒毛膜促性腺激素(β-HCG)、降钙素原(PCT)及中性粒细胞淋巴细胞比值(NLR)诊断未足月胎膜早破(PPROM)宫内感染的临床意义。方法选取2020年1月至2021年1月潍坊市妇幼保健院收治的109例PPROM孕妇作为研究对象,产前分别检测血清β-HCG、PCT水平及NLR,产后留取胎膜及胎盘组织进行病理学检测。分析病理诊断结果,根据病理结果将PPROM孕妇分为宫内感染组及非宫内感染组,比较两组血清β-HCG、PCT水平及NLR,分析血清β-HCG、PCT水平及NLR与宫内感染的关系,绘制ROC曲线分析血清β-HCG、PCT水平及NLR诊断PPROM宫内感染的预测价值。结果109例PPROM孕妇中,宫内感染56例,非宫内感染53例。宫内感染组血清β-HCG、PCT水平及NLR均高于非宫内感染组,差异有统计学意义(P<0.05)。宫内感染组血清β-HCG、PCT及NLR阳性率均明显高于非宫内感染组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,血清β-HCG、PCT水平及NLR预测宫内感染的AUC(95%CI)分别为0.787(0.701~0.873)、0.773(0.681~0.865)、0.830(0.754~0.905),均具有较高预测价值;约登指数分别为0.53、0.58、0.55。结论血清β-HCG、PCT水平及NLR均与PPROM宫内感染密切相关,均具有较高预测价值,可作为PPROM合并宫内感染的预测指标。

Objective To investigate the clinical significance of serumβ-human chorionic gonadotropin(β-HCG),procalcitonin(PCT),and neu-trophil-lymphocyte ratio(NLR)in diagnosing of intrauterine infection with preterm premature rupture of membranes(PPROM).Methods 109 preg-nant women with PPROM treated in Weifang Maternal and Child Health Hospital from January 2020 to January 2021 were selected as the research subjects,the levels of serumβ-HCG,PCT,and NLR were detected before delivery,and placental and fetal membrane tissues were obtained for patho-logical examination after delivery.The pathological diagnosis results were analyzed,and the PPROM pregnant women were divided into the intra-uterine infection group and the non-intrauterine infection group according to the pathological results,the serum levels ofβ-HCG,PCT,and NLR were compared between the two groups,the relationship between serumβ-HCG,PCT and NLR and intrauterine infection was analyzed,ROC curve was drawn to analyze the predictive value of serumβ-hCG,PCT,and NLR in the diagnosis of intrauterine infection of PPROM.Results Among the 109 pregnant women with PPROM,there were 56 cases of intrauterine infection and 53 cases of non-intrauterine infection.The levels ofβ-HCG,PCT and NLR in the intrauterine infection group were higher than those in the non-intrauterine infection group,and the differences were statistically significant(P<0.05).The positive rates ofβ-HCG,PCT and NLR in the intrauterine infection group were significantly higher than those in the non-intrauterine infection group,and the difference was statistically significant(P<0.05).ROC curve analysis results showed that the AUC(95%CI)of serumβ-HCG,PCT and NLR in predicting intrauterine infection were 0.787(0.701-0.873),0.773(0.681-0.865)and 0.830(0.754-0.905),respective-ly;the Jorden index was 0.53,0.58 and 0.55 respectively.Conclusion Serum levels ofβ-HCG,PCT,and NLR are closely related to intrauterine in-fection in PPROM,all of which have high predictive value and can be used to predictive indexes of PPROM combined with intrauterine infection.