血小板相关参数、D-二聚体及B族链球菌对孕晚期孕妇发生早产及胎膜早破的预测价值

The Predictive Value of Platelet Related Parameters,D-dimer and B-cluster Streptococcus for Premature Rupture of Membranes in Preterm Delivery

目的探讨血小板相关参数,如血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、血小板分布宽度(PDW)及D-二聚体和B族链球菌对孕晚期孕妇发生早产及胎膜早破的预测价值。方法回顾2020年1月至2022年6月期间在我院妇产科住院分娩的产妇192例,根据孕产妇的年龄分为适龄组(≤32岁,n=124)、高龄组(>32岁,n=68);根据是否发生早产及胎膜早破分为在正常分娩组(n=140)及早产胎膜早破组(n=52)。采用Logistic回归分析早产胎膜早破的影响因素、受试者工作特征(ROC)曲线分析各指标对预测早产胎膜早破的价值。结果PLT(OR=1.305,95%CI 1.017~1.326)、PCT(OR=1.952,95%CI 1.331~2.568)、MPV(OR=2.309,95%CI 1.314~2.975)、PDW(OR=1.832,95%CI 1.177~2.631)、D-D(OR=1.934,95%CI 1.516~2.874)以及B族链球菌感染(OR=1.689,95%CI 1.394~3.562)是发生早产胎膜早破的独立危险因素。PLT、PCT、MPV、PDW、D-D及B族链球菌感染预测早产胎膜早破的AUC为分别为0.732、0.756、0.767、0.791、0.825、0.848,当以上指标联合时,AUC可提高至0.913。结论PLT、PCT、MPV、PDW、D-D及B族链球菌感染是PPROM的影响因素,对预测早产胎膜早破具有重要临床价值。

Objective To investigate the predictive value of platelet-related parameters,including platelet count(PLT),platelet hematocrit(PCT),mean platelet volume(MPV),platelet distribution width(PDW),D-dimer(D-D)and group B Streptococcus during the third trimester of pregnancy,in the occurrence of preterm birth and premature rupture of membranes.Methods A total of 192 women who were hospitalized in the Department of Obstetrics and Gynecology of our hospital from January,2020 to June,2022 were retrospectively divided into the appropriate age group(≤32 years old,n=124)and advanced age group(>32 years,n=68)according to their age distributions.According to the presence of preterm labor and premature rupture of membranes,these subjects were divided into the normal delivery group(n=140)and the preterm prelabour rupture group(n=52).Logistic regression was utilized to identify the influencing factors of premature rupture of membranes in premature birth,while the value of various indicators in predicting premature rupture of membranes was evaluated by receiver operating characteristic(ROC)curve analysis.Results PLT(OR=1.305,95%CI 1.017-1.326),PCT(OR=1.952,95%CI 1.331-2.568),MPV(OR=2.309,95%CI 1.314-2.975),PDW(OR=1.832,95%CI 1.177-2.631),D-D(OR=1.934,95%CI 1.516-2.874),and Group B streptococcal infection(OR=1.689,95%CI 1.394-3.562)had respective AUCs of 0.732,0.756,0.767,0.791,0.825,and 0.848 for predicting preterm premature rupture of membranes.When these indicators were combined,the AUC was further increased to 0.913.Conclusion PLT,PCT,MPV,PDW,D-D,and B-cluster streptococcal infections are influencing factors of PPROM and have important clinical values in predicting premature rupture of membranes in premature delivery.