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目的:探讨血清绒毛膜促性腺激素(β-HCG)、高敏C-反应蛋白(hsCRP)及新蝶呤(Npt)在足月胎膜早破孕妇中的诊断价值及其与羊膜腔感染的关系。方法:选取行剖宫产分娩的185例足月胎膜早破孕妇为研究对象(观察组),另选取同期行剖宫产分娩的180例正常孕妇为对照组,采用放射免疫法测定两组Npt水平,化学发光法测定β-HCG、免疫散射比浊法测定hsCRP。结果:与对照组相比,观察组血清β-HCG、hsCRP、Npt水平显著升高,差异有统计学意义(P<0.05)。与轻、中度羊膜腔感染相比,重度羊膜腔感染血清β-HCG、hsCRP、Npt水平显著升高,差异有统计学意义(P<0.05)。经受试者工作特征曲线(ROC)分析可知,β-HCG+hsCRP+Npt联合检测羊膜腔感染敏感性、特异性高于β-HCG、hsCRP、Npt单一诊断,差异有统计学意义(P<0.05)。结论:血清β-HCG、hsCRP、Npt水平可作为足月胎膜早破孕妇羊膜腔感染的预测指标,三者联合诊断可提高诊断敏感性及特异性。
Objective: To investigate the diagnostic value of serum chorionic gonadotropin (β-HCG), high-sensitivity C-reactive protein (hsCRP) and neptin (Npt) in term pregnant women with premature rupture of membranes and its relationship with amniotic cavity infection . Methods: A total of 185 pregnant women with full-term premature rupture of membranes in cesarean delivery were selected as the study group (observation group). Another 180 pregnant women undergoing cesarean delivery during the same period were selected as the control group. Radioimmunoassay Npt level, β-HCG by chemiluminescence method and hsCRP by immune nephelometry. Results: Compared with the control group, the serum levels of β-HCG, hsCRP and Npt in the observation group were significantly increased (P <0.05). Compared with mild and moderate amniotic cavity infection, the levels of serum β-HCG, hsCRP and Npt in severe amniotic infection were significantly increased (P <0.05). The sensitivity and specificity of combined detection of β-HCG + hsCRP + Npt were higher than those of β-HCG, hsCRP and Npt (P <0.05) by ROC analysis ). Conclusion: Serum β-HCG, hsCRP and Npt levels can be used as predictors of amniotic infection in term preterm premature rupture of membranes. The combination of the three can improve the diagnostic sensitivity and specificity.