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目的 :探讨妊娠中期羊水中白介素(interleukin,IL)-6和IL-16水平与妊娠结局的相关性,了解其预测早产的准确性,寻求新的预测早产的方法。方法:采集2012年9月—2013年9月在南京医科大学第一附属医院产前诊断中心行羊膜腔穿刺染色体核型分析的孕妇羊水,采用ELISA法检测其IL-6和IL-16水平。同时对孕妇妊娠结局进行随防,观察流产、早产、足月产的发生情况。随访410例羊膜腔穿刺孕妇的妊娠结局:312例足月产,25例自发性早产,3例治疗性早产,44例孕中期引产,26例失访。选择自发性早产者作为研究组,选择同期足月分娩者25例为对照组,分析羊水中IL-6和IL-16的水平。结果:羊水IL-6水平与分娩孕周呈负相关(r=-0.707,P<0.05);IL-16水平与分娩孕周呈负相关(r=-0.767,P<0.05);IL-6和IL-16水平呈正相关(r=0.581,P<0.05)。研究组IL-6和IL-16水平均高于对照组,差异有统计学意义(P<0.05)。IL-6的最佳界定值为133.88 pg/m L,IL-16的最佳界定值为181.02 pg/m L;IL-6、IL-16预测早产的敏感度分别为92.00%、96.00%,特异度92.00%、80.00%,阳性预测值92.00%、82.80%,阴性预测值为92.00%、95.20%;联合检测IL-6和IL-16预测早产的并联敏感度78.1%、并联特异度100.0%,串联敏感度100.0%、串联特异度89.3%。结论:妊娠中期羊水中IL-6和IL-16的水平与分娩孕周呈负相关,随着它们水平的增加,分娩间隔缩短,发生早产的可能性增加;IL-6和IL-16呈正相关,二者均是敏感炎症标志物。IL-6和IL-16均是预测早产较为敏感的指标,联合检测两项指标能提高早产预测能力。
Objective: To investigate the correlation between the level of interleukin (IL) -6 and IL-16 in amniotic fluid and the pregnancy outcome in the second trimester of pregnancy, and to find out its accuracy in predicting preterm delivery and finding new methods to predict preterm delivery. Methods: Amniotic fluid of amniotic fluid was analyzed by amniocentesis in the prenatal diagnosis center of the First Affiliated Hospital of Nanjing Medical University from September 2012 to September 2013. The levels of IL-6 and IL-16 were detected by ELISA. At the same time pregnant women with pregnancy outcome with anti-observed abortion, premature birth, full-term occurrence of the situation. 410 cases of amniocentesis were followed up for pregnant women: 312 cases had full-term birth, 25 cases had spontaneous preterm birth, 3 cases had therapeutic premature birth, 44 cases had mid-term labor induction and 26 cases lost their follow-up. Select spontaneous preterm labor as a research group, select the same period 25 cases of full-term delivery as a control group, analysis of amniotic fluid levels of IL-6 and IL-16. Results: The level of IL-6 in amniotic fluid was negatively correlated with gestational age (r = -0.707, P <0.05); the level of IL-16 was negatively correlated with gestational age (r = -0.767, And IL-16 levels were positively correlated (r = 0.581, P <0.05). The levels of IL-6 and IL-16 in the study group were significantly higher than those in the control group (P <0.05). IL-6 was the best defined value of 133.88 pg / m L, IL-16 best defined value of 181.02 pg / m L; The sensitivity of IL-6, IL-16 prediction of preterm birth were 92.00%, 96.00% The positive predictive value was 92.00%, the positive predictive value was 82.00%, the negative predictive value was 92.00%, the specificity was 95.20%. The combined detection of IL-6 and IL-16 was 78.1%, the parallel specificity was 100.0% , Series sensitivity of 100.0%, series specificity of 89.3%. CONCLUSIONS: The levels of IL-6 and IL-16 in amniotic fluid during the second trimester of pregnancy are negatively correlated with the gestational weeks of childbirth. With the increase of their levels, the interval of delivery is shortened and the probability of premature delivery is increased. The positive correlation between IL-6 and IL-16 , Both sensitive markers of inflammation. Both IL-6 and IL-16 are more sensitive predictors of preterm labor, and the combination of both measures can improve the predictive power of preterm labor.