摘要
目的:探究基质金属蛋白酶-9(MMP-9)、白细胞介素-6(IL-6)、C反应蛋白(CRP)在足月胎膜早破感染中的表达及对预后的影响。方法:选取2022年12月—2023年12月梅州市人民医院接受诊疗的39例足月胎膜早破孕妇作为观察组,并根据胎膜早破孕妇感染情况将其分为非感染组(n=23)和感染组(n=16)。另选取同期入住医院产科的39例足月分娩孕妇作为对照组。三组孕妇均检测血清MMP-9、IL-6、CRP的浓度。比较对照组与观察组孕妇血清MMP-9、IL-6、CRP水平;比较非感染组与感染组孕妇MMP-9、IL-6、CRP水平;分析MMP-9、IL-6、CRP单一及联合检测诊断足月胎膜早破孕妇宫内感染的诊断效能(敏感度、特异度、阳性预测值、阴性预测值),并绘制受试者工作特征曲线(ROC)曲线。结果:观察组孕妇血清MMP-9、IL-6、CRP水平较对照组高,差异均有统计学意义(t=2.273、2.750、24.916,P<0.05)。感染组孕妇血清MMP-9、IL-6、CRP水平较对照组高,差异均有统计学意义(t=3.176、5.667、15.970,P<0.05)。联合检测的敏感度、特异度、阳性预测值、阴性预测值高于MMP-9、IL-6、CRP单一检测的效能,差异有统计学意义(P<0.05);且分析ROC曲线发现,血清MMP-9≥70.82 ng/L时,曲线下面积(AUC)为0.731,诊断敏感度为62.50%、特异度为78.26%;血清IL-6≥5.68 pg/mL时,AUC为0.752,诊断敏感度为56.25%、特异度为73.91%;血清CRP≥6.85 mg/L时,AUC为0.715,诊断敏感度为55.56%、特异度为76.19%。联合检测诊断的AUC为0.873,诊断敏感度为93.75%、特异度为95.65%。结论:足月胎膜早破感染孕妇的血清MMP-9、IL-6、CRP高于足月分娩孕妇以及足月胎膜早破未感染孕妇,且血清MMP-9、IL-6、CRP联合诊断的诊断效能更高,可作为联合预测足月胎膜早破感染的重要指标,对于足月胎膜早破感染孕妇预后改善有积极的指导意义。
Objective:To investigate the expression of matrix metalloproteinase-9(MMP-9)interleukin-6(IL-6)and C-reactive protein(CRP)in premature rupture of fetal membrane and its influence on prognosis.Methods:39 full-term pregnant women with premature rupture of membranes who received diagnosis and treatment in the obstetrics and gynecology department of the hospital from December 2022 to December 2023 were collected as the research subjects.They were divided into non-infected group(n=23)and infected group(n=16)according to the infection status of pregnant women with premature rupture of membranes.In addition,39 pregnant women with full-term delivery admitted to the obstetrics department of the hospital during the same period were selected as the control group.The concentrations of serum MMP-9,IL-6 and CRP were detected.The serum levels of MMP-9,IL-6 and CRP were compared between control group and observation group.The levels of MMP-9,IL-6 and CRP were compared between the non-infected group and the infected group.The diagnostic efficacy(sensitivity,specificity and predictive value of positive and negative)of single and combined MMP-9,IL-6 and CRP in the diagnosis of intrauterine infection in pregnant women with premature rupture of membranes was analyzed,and receiver operating characteristic curve(ROC)curve was drawn.Results:The observation group had significantly higher serum levels of MMP-9,IL-6 and CRP than the control group(t=2.273,2.750,24.916;P<0.05).The serum levels of MMP-9,IL-6 and CRP in the infection group were higher than those in the control group(t=3.176,5.667,15.970;P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of combined detection were higher than those of single detection of MMP-9,IL-6 and CRP(P<0.05).ROC curve analysis showed that when serum was MMP-9≥70.82 ng/L,the area under the curve(AUC)was 0.731,the diagnostic sensitivity was 62.50%,and the specificity was 78.26%.When serum IL-6≥5.68 pg/ml,the AUC was 0.752,the diagnostic sensitivity was 56.25%,and
作者
胡永和
何艳红
蓝柳冰
Hu Yonghe;He Yanhong;Lan Liubing(Department of Obstetrics,Meizhou People’s Hospital,Meizhou,Guangdong,514000,China)
出处
《黑龙江医学》
2024年第22期2691-2695,共5页
Heilongjiang Medical Journal
基金
梅州市科技计划项目(231219102051211)。
关键词
足月胎膜早破感染
基质金属蛋白酶-9
白细胞介素-6
C反应蛋白
预后
Premature rupture infection of term membranes
Matrix metalloproteinase-9
Interleukin-6
C-reactive protein
Prognosis
