血清CRP、PCT联合检测对未足月胎膜早破合并绒毛膜羊膜炎的诊断价值

发布时间：2018-10-05 07:07

【摘要】：目的探讨联合检测血清C-反应蛋白(CRP)和降钙素原(PCT)对未足月胎膜早破合并绒毛膜羊膜炎的诊断价值,血清CRP和PCT水平与胎膜早破时间及绒毛膜羊膜炎发生率的相关性。方法选择200例未足月胎膜早破孕妇为观察组,其中破膜至分娩时间≥24h为长时组110例,破膜至分娩时间24h为短时组90例,正常未足月孕妇120例为对照组。检测产前各组血清CRP、PCT水平,产后通过病理学检测胎盘组织中中性粒细胞/淋巴细胞量诊断绒毛膜羊膜炎,计算血清CRP、PCT、CRP+PCT诊断绒毛膜羊膜炎的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比及阴性似然比。结果观察组中长时组应用抗生素前血清CRP、PCT水平均高于短时组及对照2组入院2h内,长时、短时2组入院2h内血清PCT水平均高于对照组入院2h内(均p0.05)。胎膜早破时间(t)与血清CRP水平之间呈直线正相关(r=0.533,p0.05)。胎膜早破时间(t)与血清PCT水平之间呈直线正相关(r=0.649,p0.05)。血清PCT诊断绒毛膜羊膜炎的敏感性、特异性、阳性预测值及阴性预测值与血清CRP诊断比较差异无统计学意义(p0.05)。血清CRP+PCT联合诊断绒毛膜羊膜炎的敏感性、特异性、阳性预测值及阴性预测值均高于血清CRP、PCT诊断(均p0.05);血清CRP+PCT联合诊断绒毛膜羊膜炎的阳性似然比高于血清CRP、PCT诊断,阴性似然比低于血清CRP、PCT诊断。结论血清CRP、PCT联合检测对未足月胎膜早破并发绒毛膜羊膜炎的有重要的诊断价值。胎膜早破时间越长,血清CRP、PCT水平越高,绒毛膜羊膜炎的发生率也越高。
[Abstract]:Objective to investigate the diagnostic value of combined detection of serum C-reactive protein (CRP) and procalcitonin (PCT) in the diagnosis of premature rupture of unmatured membranes with chorioamnionitis, and the correlation between serum CRP and PCT levels and the time of premature rupture of membranes and the incidence of chorioamnionitis. Methods 200 pregnant women with premature rupture of unmatured membranes were selected as the observation group. 110 cases in the long time group, 90 cases in the short term group and 120 cases in the control group. The levels of serum CRP,PCT were measured in each group before and after delivery. The sensitivity, specificity and positive predictive value of serum CRP,PCT,CRP PCT in the diagnosis of chorioamnionitis were calculated by pathological examination of neutrophils / lymphocytes in placenta. Negative predictive value, positive likelihood ratio and negative likelihood ratio. Results the serum CRP,PCT levels in the observation group were significantly higher than those in the control group and the control group within 2 hours before antibiotic administration. The serum PCT levels in the observation group were significantly higher than those in the control group within 2 h after admission (p0.05). There was a linear positive correlation between the time of premature rupture of membranes (t) and the level of serum CRP (r = 0.533p0.05). There was a linear positive correlation between (t) and serum PCT level (r = 0. 649, p 0. 05). The sensitivity, specificity, positive predictive value and negative predictive value of serum PCT in the diagnosis of chorioamnionitis were not significantly different from those in serum CRP (p0.05). The sensitivity, specificity, positive predictive value and negative predictive value of serum CRP PCT in the diagnosis of chorioamnionitis were higher than those in serum CRP,PCT (all p0.05), and the positive likelihood ratio of serum CRP PCT combined in the diagnosis of chorioamnionitis was higher than that in serum CRP,PCT. Negative likelihood ratio was lower than serum CRP,PCT diagnosis. Conclusion the combined detection of serum CRP,PCT has important diagnostic value for premature rupture of unmatured membranes complicated with chorioamnionitis. The longer the premature rupture of membranes, the higher the level of serum CRP,PCT and the higher the incidence of chorioamnionitis.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.433

【参考文献】