摘要
目的分析胰岛素生长因子结合蛋白-1(IGFBP-1)、降钙素原(PCT)联合C-反应蛋白(CRP)检测在胎膜早破(PROM)并发绒毛膜羊膜炎(HCA)中的预测价值。方法收集2020年1月至2023年1月北京市大兴区人民医院收治的128例PROM孕妇的临床资料,其中PROM并发HCA者37例(HCA组),单纯PROM 91例(非HCA组),对比HCA组与非HCA临床资料以及IGFBP-1、PCT、CRP表达情况,采用logistic回归分析影响PROM并发HCA的危险因素,绘制ROC曲线分析IGFBP-1、PCT、CRP对PROM并发HCA的预测效果。结果HCA组与非HCA组在人工流产史、年龄、孕周、孕次、胎位中比较,差异无统计学意义(P>0.05),HCA组破膜孕周<35周、PROM潜伏期≥48 h占比、IGFBP-1、PCT、CRP水平均明显高于非HCA组,差异有统计学意义(P<0.05);以是否发生HCA设为因变量(y=0,1),Logistic回归分析结果显示:破膜孕周<35周、PROM潜伏期≥48 h、IGFBP-1升高、PCT升高、CRP升高为影响PROM并发HCA的独立危险因素(P<0.05);ROC结果显示:IGFBP-1、PCT、CRP三者联合检测预测PROM并发HCA的灵敏度、特异度为0.976、0.910,三者联合诊断显著高于三者单独预测(P<0.05)。结论IGFBP-1、PCT、CRP在PROM并发HCA患者中表达水平明显升高,三指标联合检测有助于更好地预测HCA发生,为临床决策提供参考依据。
Objective To analyze the predictive value of insulin growth factor binding protein⁃1(IGFBP⁃1),procalcitonin(PCT)and C⁃reactive protein(CRP)in premature rupture of membranes(PROM)complicated with chorioamnionitis(HCA).Methods The clinical data of 128 pregnant women with PROM ad⁃mitted to the Daxing District Peoples Hospital of Beijing from January 2020 to January 2023 were collected.This included 37 cases of PROM complicated with HCA(HCA group)and 91 cases of simple PROM(non⁃HCA group).The clinical data and the levels of IGFBP⁃1,PCT and CRP were compared between the HCA group and the non⁃HCA group.Logistic regression analysis was used to analyze the risk factors of PROM complicated with HCA,and the ROC curve was plotted to analyze the predictive effect of IGFBP⁃1,PCT and CRP on PROM com⁃plicated with HCA.Results There were no significant differences between the HCA group and the non⁃HCA group in the terms of history of induced abortion,age,gestational age,gravidity,and fetal position(P>0.05).However,the HCA group did have significantly higher proportions of PROM gestation weeks<35 weeks,PROM latency≥48 hours,and levels of IGFBP⁃1,PCT,and CRP compared to the non⁃HCA group,with the difference being statistically significant(P<0.05).When considering the occurrence of HCA as the dependent variable(y=0,1),logistic regression analysis showed that PROM gestational age<35 weeks,PROM latency≥48 h,increased levels of IGFBP⁃1,PCT,and CRP were independent risk factors for PROM complicated with HCA(P<0.05).Further,ROC results indicated that the sensitivity and specificity of the combined detection of IGFBP⁃1,PCT and CRP in predicting PROM complicated with HCA were 0.976 and 0.910,respectively.The combined diagnosis of the three biomarkers was significantly more accurate than each one alone(P<0.05).Conclusion The levels of IGFBP⁃1,PCT,and CRP expression are significantly increased in patients with PROM complicated by HCA.The combined detection of IGFBP⁃1,PCT,and CRP can improve the prediction
作者
宋风丽
马丽丽
贺笑茜
SONG Fengli;MA Lili;HE Xiaoqian(Department of Obstetrics and Gynecology,Beijing Daxing Peoples Hospital,Beijing,China,102600)
出处
《分子诊断与治疗杂志》
2024年第4期608-611,共4页
Journal of Molecular Diagnostics and Therapy
基金
北京市卫生健康科技成果和适宜技术推广项目(BHTPP2022011)。
