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临床输血与检验

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (1): 96-99.DOI: 10.3969/j.issn.1671-2587.2020.01.023

• 临床检验 • 上一篇    下一篇

血清β-hCG、ICAM-1、MMP-9在足月胎膜早破宫内感染及预后中的临床评价意义

杨帆, 安晓霞, 程亚华   

  1. 100101 北京亚运村美中宜和妇儿医院妇产科
  • 收稿日期:2018-03-08 出版日期:2020-02-20 发布日期:2020-02-28
  • 作者简介:杨帆(1982-),女,山西太原人,主治医师,硕士,主要从事妇科肿瘤研究工作,(Tel)15810655025。

Significance of Serum β-hCG,ICAM-1 and MMP9 in Intrauterine Premature Infection and Prognosis of Premature Rupture of Membranes

YANG Fan, AN Xiao-xia, CHENG Ya-hua   

  1. Department of Obstetrics and Gynecology,Beijing Asian Sports Village amcare women's and children's Hospital,Beijing 100101
  • Received:2018-03-08 Online:2020-02-20 Published:2020-02-28

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摘要： 目的 探究血清β-hCG、ICAM-1、MMP9在足月胎膜早破宫内感染及预后中的临床评价意义。方法 收集某院收治的296例胎膜早破孕妇为研究对象,所有患者均于产前空腹抽取静脉血,经处理后检测孕妇血清中β-hCG、ICAM-1、MMP9水平,当孕妇分娩后留取胎膜和胎盘组织进行临床检查,判断其是否存在组织绒毛膜炎,然后根据患者的感染情况将其分为非感染组和感染组,其中非感染组184例,感染组112例;然后再对两组孕妇的血清β-hCG、ICAM-1、MMP9水平进行比较,并对两组患者的预后情况进行评估。结果 非感染组患者的血清MMP9、ICAM-1、β-hCG水平均明显低于感染组,差异显著,存在统计学意义(P<0.05)。血清MMP9、ICAM-1、β-hCG水平预测胎膜早破宫内感染价值比较,敏感性、特异性和精确度经比较ICAM-1>MMP9>β-hCG,阳性预测价值MMP9>ICAM-1>β-hCG,阴性预测价值MMP9>β-hCG>ICAM-1,但经过χ2检验比较,差异无统计学意义,P>0.05;上述血清指标联合检测对胎膜早破宫内感染的预测价值经比较,三者联合检测与两两联合检测相比,敏感度与特异度均无显著差异(P>0.05),但精确度明显升高(P<0.05);血清MMP9、ICAM-1、β-hCG阳性患者的抗菌药物使用时间和住院时间均明显高于MMP9、ICAM-1、β-hCG阴性患者(P<0.05)。讨论 检测足月胎膜早破孕妇的血清β-hCG、ICAM-1、MMP9水平均可以较为准确的预测孕妇宫内感染的情况,并可以更好的预测患者的预后情况。

关键词: β—绒毛膜促性腺激素, 细胞间黏附分子-1, 基质金属蛋白酶9, 胎膜早破, 宫内感染

Abstract: Objective To investigate the clinical significance of serum β-hCG, ICAM-1 and MMP9 in the intrauterine infection and prognosis of premature rupture of membranes. Methods 296 patients with precancerous premature rupture of membranes were collected. Blood samples were drawn at the time of prenatal fasting. After treatment, the serum levels of β-hCG, ICAM-1 and MMP9 were measured. The patients were divided into non-infected group and infected group according to the infection status of the patients. There were 184 cases of non-infected group and 112 cases of infection group. Then, Serum levels of β-hCG, ICAM-1 and MMP9 were compared between the two groups, and the prognosis of the two groups was evaluated. Results The levels of MMP9, ICAM-1 and β-hCG in the non-infected group were significantly lower than those in the infection group (P<0.05). Serum MMP9, ICAM-1 and β-hCG levels were predictive of the value of intrauterine infection, the sensitivity, specificity and accuracy of ICAM-1>MMP9>β-hCG, the positive predictive value of MMP9>ICAM-1>β-hCG, The predicted value of MMP9>β-hCG> ICAM-1, but after χ2 test, no significant statistical difference, P>0.05; The combined value of the above serum markers for the predictive value of intrauterine infection in premature rupture of membranes was compared. Compared with the combined detection of the two, there was no significant difference in sensitivity and specificity (P>0.05), but the accuracy was significantly higher (P<0.05).The time and length of hospitalization of antibiotics in patients with MMP9, ICAM-1 and β-hCG positive were significantly higher than those in MMP9, ICAM-1 and β-hCG negative patients (P<0.05). Conclusion Detection of serum β-hCG, ICAM-1 and MMP9 levels in pregnant women with premature rupture of membranes can predict the situation of intrauterine infection in pregnant women more accurately and can predict the prognosis of patients.

Key words: β-hCG, ICAM-1, MMP9, Premature rupture of membranes, Intrauterine infection

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