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目的分析血清C反应蛋白(CRP)、白介素-6(IL-6)水平在绒毛膜羊膜炎中的诊断价值。方法选择2012年10-2014年10月诊断胎膜早破患者135例,入院后分别给予双抗体夹心ELLSA法检测血清CRP水平,酶联免疫吸附法检测血清IL-6水平。产后均给予胎膜病理检查,确定绒毛膜羊膜炎诊断及病变严重程度。以血清CRP、IL-6水平绘制受试者工作特征曲线(ROC)预测判断患者临床预后及血清CRP、IL-6水平与绒毛膜羊膜炎严重程度之间关系。结果产后组织学诊断无羊膜炎者67例,绒毛膜羊膜炎组患者109例,其中,Ⅰ级75例,Ⅱ级26例,Ⅲ级8例。羊膜炎组患者血CRP及IL-6水平均高于无羊膜炎组,差异均有统计学意义(P<0.05)。以血清CRP、IL-6水平绘制受试者工作特征曲线(ROC)预测判断患者绒毛膜羊膜炎发生(AUC)曲线下面积分别为(0.735;0.683),以CRP水平≥34.81mg/L为截断点,判断患者绒毛膜羊膜炎诊断的灵敏度为89.3%,特异度为53.16%。以IL-6水平≥45.82ng/L为截断点,判断患者绒毛膜羊膜炎诊断的灵敏度为81.37%,特异度为56.83%。结论胎膜早破患者血清CRP、IL-6水平明显升高,血清CRP、IL-6水平与绒毛膜羊膜炎病情程度存在一定关系,血清CRP、IL-6水平升高对于诊断绒毛膜羊膜炎具有一定预测价值。
Objective To analyze the diagnostic value of serum C-reactive protein (CRP) and interleukin-6 (IL-6) in chorioamnionitis. Methods A total of 135 patients with premature rupture of membranes diagnosed from October to October 2014 were enrolled. Serum CRP levels were measured by ELLSA sandwich ELISA and serum IL-6 levels by enzyme-linked immunosorbent assay. Postpartum were given fetal pathological examination to determine the diagnosis of chorioamnionitis and lesion severity. The relationship between the clinical prognosis and serum CRP, IL-6 levels and the severity of chorioamnionitis was predicted by using the receiver operating characteristic curve (ROC) of serum CRP and IL-6 levels. Results Postpartum histological diagnosis of amniotic inflammation in 67 cases, chorioamnionitis group of 109 patients, of which Ⅰ grade 75 cases, Ⅱ grade 26 cases, Ⅲ grade 8 cases. The levels of CRP and IL-6 in amniotic group were significantly higher than those without amniocentesis (P <0.05). The area under the curve of AUC curve predicted by ROC and serum CRP, IL-6 levels was (0.735; 0.683), respectively, and the CRP level was 34.81 mg / L Point to determine the sensitivity of the diagnosis of chorioamnionitis was 89.3%, specificity was 53.16%. To IL-6 levels ≥ 45.82ng / L as a cut-off point, the diagnosis of chorioamnionitis patients with sensitivity was 81.37%, specificity was 56.83%. Conclusion Serum levels of CRP and IL-6 are significantly elevated in patients with premature rupture of membranes, serum levels of CRP and IL-6 are related to the severity of chorioamnionitis. Elevated serum levels of CRP and IL-6 may contribute to the diagnosis of chorioamnionitis Has some predictive value.