妊娠期胎膜早破患者血清GATA-3及MIP-3Α水平对羊膜腔内感染的诊断价值

Value of serum GATA-3 and MIP-3α levels in diagnosis of intra-amniotic infection in patients with premature rupture of membranes

目的探讨妊娠期胎膜早破患者血清GATA结合蛋白-3(GATA-3)联合巨噬细胞炎性蛋白-3α(MIP-3α)水平对羊膜腔内感染的诊断价值。方法回顾性分析,选取2021年10月至2023年8月在渭南市中心医院治疗的123例妊娠期胎膜早破患者作为研究对象,将是否发生羊膜腔内感染分为感染组(53例)和未感染组(70例)。感染组年龄(27.65±3.58)岁,孕周(36.47±3.04)周;未感染组年龄(27.71±3.69)岁,孕周(37.52±3.27)周。对比两组患者产前血清GATA-3和MIP-3α水平。受试者工作特征曲线(ROC)评估GATA-3、MIP-3α水平对妊娠期胎膜早破患者发生羊膜腔内感染的诊断价值,多因素logistic回归分析影响妊娠期胎膜早破患者发生羊膜腔内感染的危险因素。统计学方法采用t检验、χ^(2)检验。结果感染组血清GATA-3水平低于未感染组[(261.35±27.87)ng/L比(292.87±29.53)ng/L],MIP-3α水平高于未感染组[(38.84±6.33)μg/L比(29.61±5.62)μg/L],差异均有统计学意义(t=6.005、8.540,均P<0.05)。GATA-3、MIP-3α预测胎膜早破合并羊膜腔内感染的曲线下面积(AUC)分别为0.789、0.855,截断值分别为276.74 ng/L、36.04μg/L,特异度分别为77.4%、88.6%,灵敏度分别为75.7%、71.7%,二者联合检测的AUC为0.924,特异度为94.3%,灵敏度为81.1%。GATA-3≤276.74 ng/L、MIP-3α≥36.04μg/L、有流产及引产史、未足月胎膜早破是妊娠期胎膜早破患者发生羊膜腔内感染的独立风险因素(均P<0.05)。结论血清GATA-3、MIP-3α水平异常是影响胎膜早破患者并发羊膜腔内感染的危险因素,对于羊膜腔内感染的诊断具有较高价值。

Objective To investigate the value of serum GATA binding protein-3(GATA-3)and macrophage inflammatory protein-3α(MIP-3α)levels in the diagnosis of intra-amniotic infection in patients with premature rupture of membranes.Methods The clinical data of 123 patients with premature rupture of membranes treated in Weinan Central Hospital from October 2021 to August 2023 were retrospectively collected.The fifty-three patients who developed intra-amniotic infection were set as an infection group,while the 70 patients without infection were set as a non-infection group.The infection group were(27.65±3.58)years old and(36.47±3.04)weeks pregnant.The non-infection group were(27.71±3.69)years old and(37.52±3.27)weeks pregnant.The prenatal serum levels of GATA-3 and mip-3αin both groups were compared.t and χ^(2) tests and receiver operating characteristic curve(ROC)were used to assess the value of GATA-3 and MIP-3αin the diagnosis of amniotic cavity infection in patients with premature rupture of membranes.Multivariate logistic regression analysis was conducted to identify the risk factors of amniotic cavity infections in the patients with premature rupture of membranes.Results The levels of GATA-3 and MIP-3αin the infection group were(261.35±27.87)ng/L and(38.84±6.33)μg/L,and those in the non-infection group were(292.87±29.53)ng/L and(29.61±5.62)μg/L,with statistical differences(t=6.005 and 8.540;both P<0.05).The areas under the curves(AUC)of GATA-3 and MIP-3αfor predicting intra-amniotic infection in the patients with PPROM were 0.789 and 0.855,respectively;the cutoff values were 276.74 ng/L and 36.04μg/L;the specificities were 77.4%and 88.6%;the sensitivities were 75.7%and 71.7%.The combined detection of both had an AUC of 0.924,with a specificity of 94.3%and a sensitivity of 81.1%.GATA-3≤276.74 ng/L,MIP-3α≥36.04μg/L,history of miscarriage and induced abortion,and premature rupture of membranes were independent risk factors for intra-amniotic infection in the patients with premature rupture of membranes(all P<0.05).Conclusion Abnormal serum levels of GATA-3 and MIP-3αin patients with premature rupture of membranes are risk factors for intra-amniotic infection,and have high diagnostic value for this condition.