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目的探讨孕妇血清可溶性人白细胞抗原G(sHLA-G)测定在诊断妊娠合并亚临床绒毛膜羊膜炎中的意义。方法选取早产及胎膜早破孕产妇115例及正常足月分娩孕产妇40例,通过运用双抗体夹心酶联免疫吸附(ELISA)法检测上述研究对象血清中sHLA-G的水平,同时用散射比浊法测定其中C反应蛋白(CRP)含量,最后对所有产后胎膜进行病理检查,判断有无绒毛膜羊膜炎。结果①通过对产后胎膜组织进行病理检查,共检测出绒毛膜羊膜炎患者70例,作为研究组,另外85例无绒毛膜羊膜炎患者作为对照组;②研究组血清中sHLA-G的水平平均为(46.52±13.75)U/ml,显著高于对照组(28.48±10.76U/ml),差异有统计学意义(P<0.001);③研究组血清中CRP的水平平均为(13.39±12.48)mg/L,显著高于对照组(5.49±5.45mg/L),差异有统计学意义(P<0.001);④用ROC曲线分析:血清sHLA-G检测绒毛膜羊膜炎的最佳临界值为36.09U/ml,诊断敏感性77.1%,特异性75.3%,曲线下面积0.847,明显优于CRP(敏感性68.6%,特异性68.2%,曲线下面积0.739,最佳临界值为7.5mg/L)。结论发生绒毛膜羊膜炎时,母血中sHLA-G的水平升高,与CRP相比,有更高的敏感性和特异性,提示sHLA-G是诊断亚临床绒毛膜羊膜炎的较理想的血清学指标。
Objective To investigate the significance of serum soluble human leukocyte antigen G (sHLA-G) in the diagnosis of subclinical chorioamnionitis during pregnancy. Methods 115 pregnant women with premature rupture of membranes and premature rupture of membranes and 40 pregnant women with normal term were selected. The levels of sHLA-G in sera of the above subjects were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) Turbidimetric assay C-reactive protein (CRP) content, and finally all postpartum fetal membrane pathological examination to determine the presence of chorioamnionitis. Results (1) 70 cases of chorioamnionitis were detected by pathological examination of the fetal membranes of the postpartum as the study group, and 85 cases of chorioamnionitis-free patients as the control group; ② The level of sHLA-G in the study group (46.52 ± 13.75) U / ml, which was significantly higher than that of the control group (28.48 ± 10.76U / ml), the difference was statistically significant (P <0.001) .③The CRP level in the study group was (13.39 ± 12.48 ) mg / L, which was significantly higher than that of the control group (5.49 ± 5.45mg / L) (P <0.001). ④The ROC curve analysis showed that the optimal cutoff value of serum sHLA-G for chorioamnionitis (Sensitivity 68.6%, specificity 68.2%, area under the curve 0.739, the best cut-off value 7.5 mg / ml) was 36.09 U / ml, the diagnostic sensitivity was 77.1%, the specificity was 75.3% and the area under the curve was 0.847, L). Conclusions When chorioamnionitis occurs, the level of sHLA-G in maternal blood is increased, which is higher than that of CRP, indicating that sHLA-G is more ideal for the diagnosis of subclinical chorioamnionitis Serological markers.