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目的:探讨检测并比较未足月胎膜早破(PPROM)孕妇血清细胞间黏附分子-1(ICAM-1)与降钙素原(PCT)浓度水平对诊断绒毛膜羊膜炎的作用。方法:应用病例对照研究,收集PPROM患者60例,正常健康孕妇30例,分别检测所有病例的血清ICAM-1及PCT含量,产后进行胎膜病理检查。结果:PPROM组孕妇的血清ICAM-1和PCT浓度均明显高于对照组(P<0.05);PPROM组发生绒毛膜羊膜炎的几率为48.3%,明显高于对照组3.3%(P<0.01);PPROM组中并发绒毛膜羊膜炎患者血清ICAM-1和PCT浓度明显高于未并发绒毛膜羊膜炎者(P<0.05);ICAM-1诊断绒毛膜羊膜炎的敏感性、特异性及阳性预测值、阴性预测值优于PCT(96.6%、93.5%、93.3%、96.0%vs 65.5%、74.1%、70.3%、69.7%)。结论:血清ICAM-1是早期诊断未足月胎膜早破并发绒毛膜羊膜炎的敏感指标。
Objective: To investigate the effect of detecting serum ICAM-1 and PCT in the diagnosis of chorioamnionitis in preterm premature rupture of membranes (PPROM). Methods: A case-control study was conducted in 60 patients with PPROM and 30 healthy pregnant women. ICAM-1 and PCT levels were detected in all cases and fetal membranes were examined postpartum. Results: Serum concentrations of ICAM-1 and PCT in PPROM group were significantly higher than those in control group (P <0.05). The incidence of chorioamnionitis in PPROM group was 48.3%, significantly higher than that in control group (3.3%, P <0.01) ; The concentration of ICAM-1 and PCT in serum of patients with chorioamnionitis in PPROM group were significantly higher than those in patients without chorioamnionitis (P0.05). The sensitivity, specificity and positive predictive value of ICAM-1 in chorioamnionitis Values, negative predictive value were better than PCT (96.6%, 93.5%, 93.3%, 96.0% vs 65.5%, 74.1%, 70.3%, 69.7%). Conclusion: Serum ICAM-1 is a sensitive indicator of early diagnosis of premature rupture of membranes in patients with chorioamnionitis.