非侵入性检查模型对诊断PPROM继发绒毛膜羊膜炎的临床研究

发布时间：2018-11-05 11:54

【摘要】：目的基于非侵入性检查[血C反应蛋白(CRP)和孕周]构建模型,预测未足月胎膜早破(PPROM)孕妇继发绒毛膜羊膜炎的可能性,并评估联合侵入性检查[羊水白细胞介素-6(IL-6)]能否提高其预测值。方法共146例未足月PPROM孕妇(妊娠20~36+6周)纳入此回顾性队列研究。经阴道超声评估孕妇宫颈管长度,行羊膜腔穿刺羊水细菌培养,并进行羊水白细胞(WBC)计数及IL-6检测,抽取孕妇外周血检测血CRP水平及血WBC计数。分娩后胎盘组织送组织病理学检查。结果基于血CRP水平及孕周的非侵入性检查模型具有较好的拟合优度,其受试者工作特征曲线下面积(AUC)=0.74,与基于羊水IL-6及孕周的侵入性检查模型比较,差异无统计学意义(P0.05)。结论基于非侵入性检查(血CRP和孕周)模型对PPROM孕妇继发绒毛膜羊膜炎具有较好的预测诊断价值,且联合侵入性检查(羊水IL-6)并不能提高其预测准确率。
[Abstract]:Objective to establish a model based on noninvasive tests [serum C-reactive protein (CRP) and gestational age] to predict the possibility of chorioamnionitis secondary to premature rupture of membranes in pregnant women with (PPROM). The predictive value of amniotic fluid interleukin-6 (IL-6) was evaluated. Methods A total of 146 unterm PPROM pregnant women (2036 weeks gestation) were enrolled in this retrospective cohort study. The length of cervical canal of pregnant women was evaluated by transvaginal ultrasound. The bacterial culture of amniotic fluid was performed through amniotic cavity puncture. The (WBC) count and IL-6 of amniotic fluid were measured. The CRP level and WBC count in peripheral blood of pregnant women were measured. Histopathological examination of placenta tissue after delivery. Results the non-invasive test model based on blood CRP level and gestational age had good fit. The area under the operating characteristic curve was 0.74, which was compared with the invasive test model based on amniotic fluid IL-6 and gestational week. The difference was not statistically significant (P0.05). Conclusion based on the model of non-invasive examination (blood CRP and gestational week), it is valuable to predict the secondary chorioamnionitis in pregnant women with PPROM, and the combined invasive examination (IL-6) can not improve the accuracy of prediction.
【作者单位】：山东省临沂市中心医院产科;
【分类号】：R714.433

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