【摘要】：目的探討聯(lián)合檢測血清C-反應蛋白(CRP)和降鈣素原(PCT)對未足月胎膜早破合并絨毛膜羊膜炎的診斷價值,血清CRP和PCT水平與胎膜早破時間及絨毛膜羊膜炎發(fā)生率的相關(guān)性。方法選擇200例未足月胎膜早破孕婦為觀察組,其中破膜至分娩時間≥24h為長時組110例,破膜至分娩時間24h為短時組90例,正常未足月孕婦120例為對照組。檢測產(chǎn)前各組血清CRP、PCT水平,產(chǎn)后通過病理學檢測胎盤組織中中性粒細胞/淋巴細胞量診斷絨毛膜羊膜炎,計算血清CRP、PCT、CRP+PCT診斷絨毛膜羊膜炎的敏感性、特異性、陽性預測值、陰性預測值、陽性似然比及陰性似然比。結(jié)果觀察組中長時組應用抗生素前血清CRP、PCT水平均高于短時組及對照2組入院2h內(nèi),長時、短時2組入院2h內(nèi)血清PCT水平均高于對照組入院2h內(nèi)(均p0.05)。胎膜早破時間(t)與血清CRP水平之間呈直線正相關(guān)(r=0.533,p0.05)。胎膜早破時間(t)與血清PCT水平之間呈直線正相關(guān)(r=0.649,p0.05)。血清PCT診斷絨毛膜羊膜炎的敏感性、特異性、陽性預測值及陰性預測值與血清CRP診斷比較差異無統(tǒng)計學意義(p0.05)。血清CRP+PCT聯(lián)合診斷絨毛膜羊膜炎的敏感性、特異性、陽性預測值及陰性預測值均高于血清CRP、PCT診斷(均p0.05);血清CRP+PCT聯(lián)合診斷絨毛膜羊膜炎的陽性似然比高于血清CRP、PCT診斷,陰性似然比低于血清CRP、PCT診斷。結(jié)論血清CRP、PCT聯(lián)合檢測對未足月胎膜早破并發(fā)絨毛膜羊膜炎的有重要的診斷價值。胎膜早破時間越長,血清CRP、PCT水平越高,絨毛膜羊膜炎的發(fā)生率也越高。
[Abstract]:Objective to investigate the diagnostic value of combined detection of serum C-reactive protein (CRP) and procalcitonin (PCT) in the diagnosis of premature rupture of unmatured membranes with chorioamnionitis, and the correlation between serum CRP and PCT levels and the time of premature rupture of membranes and the incidence of chorioamnionitis. Methods 200 pregnant women with premature rupture of unmatured membranes were selected as the observation group. 110 cases in the long time group, 90 cases in the short term group and 120 cases in the control group. The levels of serum CRP,PCT were measured in each group before and after delivery. The sensitivity, specificity and positive predictive value of serum CRP,PCT,CRP PCT in the diagnosis of chorioamnionitis were calculated by pathological examination of neutrophils / lymphocytes in placenta. Negative predictive value, positive likelihood ratio and negative likelihood ratio. Results the serum CRP,PCT levels in the observation group were significantly higher than those in the control group and the control group within 2 hours before antibiotic administration. The serum PCT levels in the observation group were significantly higher than those in the control group within 2 h after admission (p0.05). There was a linear positive correlation between the time of premature rupture of membranes (t) and the level of serum CRP (r = 0.533p0.05). There was a linear positive correlation between (t) and serum PCT level (r = 0. 649, p 0. 05). The sensitivity, specificity, positive predictive value and negative predictive value of serum PCT in the diagnosis of chorioamnionitis were not significantly different from those in serum CRP (p0.05). The sensitivity, specificity, positive predictive value and negative predictive value of serum CRP PCT in the diagnosis of chorioamnionitis were higher than those in serum CRP,PCT (all p0.05), and the positive likelihood ratio of serum CRP PCT combined in the diagnosis of chorioamnionitis was higher than that in serum CRP,PCT. Negative likelihood ratio was lower than serum CRP,PCT diagnosis. Conclusion the combined detection of serum CRP,PCT has important diagnostic value for premature rupture of unmatured membranes complicated with chorioamnionitis. The longer the premature rupture of membranes, the higher the level of serum CRP,PCT and the higher the incidence of chorioamnionitis.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R714.433

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