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目的研究分析血清降钙素原(procalcitonin,PCT)联合白细胞介素-8(interleukin-8,IL-8)在预测未足月胎膜早破合并绒毛羊膜炎的应用价值。方法选取深圳市宝安区沙井人民医院2014年1月至2015年1月收治的未足月胎膜早破患者80例为研究组(其中合并绒毛膜羊膜炎60例为研究A组,未合并者20例为研究B组),同期足月胎膜早破产妇40例为对照C组,同期孕周相同的健康产妇40例为对照D组,测定并比较4组血清PCT、IL-8的浓度及阳性率,评价单一标志物检测及联合检测对绒毛膜羊膜炎的诊断价值。结果研究A组的PCT、IL-8浓度以及阳性率显著高于研究B组、对照C组和对照D组,差异有统计学意义(P<0.05);研究B组和对照C组的PCT、IL-8浓度以及阳性率也高于对照D组,差异有统计学意义(P<0.05)。PCT和IL-8对诊断绒毛膜羊膜炎的敏感性均较高(83.3%、90%),但特异性均较低(70%、65%),且误诊率均较高(30.0%、35.0%),但PCT联合IL-8检测的敏感性和特异性均较高(83.3%、90.0%),经一致性检验,其K值为0.763,表明联合检测结果与病理检查的一致性极好。结论相较于单一指标,血清PCT联合IL-8能大大提高预测未足月胎膜早破合并绒毛膜羊膜炎的准确性和可靠性。
Objective To investigate the value of serum procalcitonin (PCT) combined with interleukin-8 (IL-8) in the prediction of premature rupture of membranes combined with chorioamnionitis. Methods 80 patients with unterm ruptured membranes who were treated in Shajing People’s Hospital of Bao’an District, Shenzhen from January 2014 to January 2015 were selected as the study group (including 60 cases with chorioamnionitis in study group A, non-combined 20 cases for the study group B), 40 cases of full-term premature rupture of membranes of premature rupture of membranes in the same period as the control group C, the same gestational age the same healthy pregnant women 40 cases as control group D, determination and comparison of serum PCT, IL- And positive rate, evaluation of a single marker detection and combined detection of chorioamnionitis diagnostic value. Results The concentration of PCT and IL-8 in group A and the positive rate of group A were significantly higher than those in group B, control C and control D (P <0.05) The concentration of IL-8 and the positive rate were also higher than those of control group D (P <0.05). The sensitivity of PCT and IL-8 for diagnosis of chorioamnionitis was high (83.3%, 90%), but the specificity was low (70%, 65%) and the misdiagnosis rate was high (30.0%, 35.0 %). However, the sensitivity and specificity of PCT combined with IL-8 test were higher (83.3%, 90.0%). The consistency test showed that the K value was 0.763, which showed that the consistency of the combined test results with pathological examination was excellent . Conclusion Compared with a single index, serum PCT combined with IL-8 can greatly improve the accuracy and reliability of predicting unterm premature rupture of membranes combined with chorioamnionitis.