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目的评价羊水(AF)基质金属蛋白酶-9(MMP-9)和白细胞介素-6(IL-6)在预测羊膜腔感染中的作用。方法收集有早产、胎膜早破或临床怀疑羊膜腔感染的单胎妊娠妇女84例,经腹壁羊膜穿刺抽取羊水。AF细菌培养阳性为羊膜腔感染。测定AF中的葡萄糖(Glu),白细胞,MMP-9和IL-6。结果羊膜腔感染患者AFMMP-9和IL-6水平明显升高。且MMP-9水平与IL-6密切相关(r=0.813,P<0.01)。AFMMP-9和IL-6又与白细胞呈正相关,而与AFGlu呈负相关。将MMP-9临界值定为13.6ng/mL,则其敏感度、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为77%,98%,98%和89%。若将IL-6临界值定为8.6ng/mL,则其敏感度、特异性、PPV和NPV分别为73%,78%,60%和86%。联合检测AFMMP-9和IL-6可提高羊膜腔感染诊断的敏感度和NPV。结论羊膜腔感染患者AFMMP-9和IL-6表达水平明显升高。为预测羊膜腔感染,MMP-9比IL-6为更准确。
Objective To evaluate the role of amniotic fluid matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) in the prediction of amniotic cavity infection. Methods Eighty-four singleton pregnant women with preterm labor, premature rupture of membranes or clinical suspected amniotic infection were collected and amniotic fluid was collected by amniocentesis. AF bacterial culture positive for amniotic cavity infection. Glu (Glu), leukocytes, MMP-9 and IL-6 in AF were measured. Results The levels of AFMMP-9 and IL-6 in patients with amniotic infection were significantly higher. The level of MMP-9 was closely related to IL-6 (r = 0.813, P <0.01). AFMMP-9 and IL-6 were positively correlated with leukocytes and negatively correlated with AFGlu. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for MMP-9 at 13.6 ng / mL were 77%, 98%, 98%, and 89%, respectively. Sensitivity, specificity, PPV, and NPV were 73%, 78%, 60%, and 86%, respectively, with a cut-off of IL-6 of 8.6 ng / mL. Joint detection of AFMMP-9 and IL-6 improves the diagnostic sensitivity and NPV for amniotic infection. Conclusion The expression levels of AFMMP-9 and IL-6 in patients with amniotic cavity infection were significantly higher than those in control group. For the prediction of amniotic infection, MMP-9 is more accurate than IL-6.