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目的探讨C反应蛋白(CRP)、白介素6(IL-6)与足月胎膜早破(PROM)感染的关系。方法选择2013年1月至2014年2月于佛山市顺德区均安医院妊娠的PROM感染患者67例为观察组,同期选择妊娠正常孕妇50例作为对照组。测定两组孕妇的CRP、IL-6等水平,并将CRP≥3.33 mg/L、IL-6≥6.85×10~(-8) g/L作为参考指标。所有孕妇在分娩或者手术后使用抗生素1 d,然后在使用1 d及3 d后进行检测CRP、IL-6水平。同时比较两组孕妇分娩周期、新生儿体重及窒息情况。结果观察组CRP、IL-6水平分别为(4.38±1.09)mg/L、(7.02±2.17)×10~(-8) g/L,显著高于对照组的(3.05±0.83)mg/L、(5.33±1.34)×10~(-8) g/L,差异均有统计学意义(P<0.05)。在使用抗生素1 d后CRP、IL-6水平均出现显著的上升趋势,在使用抗生素3 d后水平比入院时及使用1 d后均更低,差异均有统计学意义(P<0.05)。依据IL-6≥6.85×10~(-8)g/L作为参考指标得到的准确度、敏感度、特异性、阳性预测值、阴性预测之依次为80.34%、80.60%、80.00%、84.38%和75.47%,均显著高于依据CRP≥3.33 mg/ml诊断的60.68%、59.70%、62.00%、67.80%及53.45%;并且观察组出现7.46%(5/67)新生儿窒息,显著高于对照组的0.00%,差异均有统计学意义(P均<0.05)。结论 PROM病患出现感染情况后CRP及IL-6水平上升明显,在准确利用抗生素治疗后得到有效改善。依据IL-6进行诊断得到的准确度、敏感度较CRP高。
Objective To investigate the relationship between C-reactive protein (CRP), interleukin-6 (IL-6) and full-term premature rupture of membranes (PROM). Methods 67 patients with PROM infection in Junan Hospital of Shunde District of Foshan City from January 2013 to February 2014 were selected as observation group and 50 pregnant women with normal pregnancy were selected as control group. The levels of CRP, IL-6 in the two groups of pregnant women were measured. CRP≥3.33 mg / L and IL-6≥6.85 × 10 ~ (-8) g / L were taken as reference indexes. All pregnant women used antibiotics for 1 d after childbirth or surgery, and then measured the levels of CRP and IL-6 after 1 d and 3 d. At the same time, we compared the delivery period, birth weight and asphyxia of pregnant women in two groups. Results The levels of CRP and IL-6 in the observation group were (4.38 ± 1.09) mg / L and (7.02 ± 2.17) × 10 -8 g / L, respectively, which were significantly higher than those in the control group (3.05 ± 0.83) mg / L , (5.33 ± 1.34) × 10 ~ (-8) g / L respectively, the differences were statistically significant (P <0.05). The levels of CRP and IL-6 all showed a significant upward trend after 1 day of antibiotic use. The level of antibiotics after 3 days was lower than that on admission and after 1 day of use, with significant differences (P <0.05). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 80.34%, 80.60%, 80.00% and 84.38% respectively according to the predictive value of IL-6≥6.85 × 10 -8 (g / L) And 75.47%, respectively, were significantly higher than 60.68%, 59.70%, 62.00%, 67.80% and 53.45% of those diagnosed according to CRP≥3.33 mg / ml, respectively; and 7.46% (5/67) neonates with asphyxia in observation group were significantly higher than 0.00% in the control group, the difference was statistically significant (P all <0.05). Conclusion The levels of CRP and IL-6 in patients with PROM increased significantly after infection and were effectively improved after antibiotics were used accurately. According to the diagnostic accuracy of IL-6, the sensitivity is higher than that of CRP.