目的: 探讨血清淀粉样蛋白A（serum amyloid A protein,SAA）、白细胞计数和C反应蛋白（C-reactive protein,CRP）在未足月胎膜早破合并绒毛膜羊膜炎中的应用价值。方法: 选取2020年1月—2021年12月株洲市中心医院收治的未足月胎膜早破患者共80例,根据分娩后胎盘病检结果分为绒毛膜羊膜炎组（n=35例,包括I级组18例、II级组10例、III级组7例）和非绒毛膜羊膜炎组（n=45例）。选取同期正常孕妇作对照组（n=40例）。测定所有孕妇入院时SAA、白细胞计数、CRP,采用ROC曲线寻找各项指标对未足月胎膜早破合并绒毛膜羊膜炎的诊断价值。结果: 绒毛膜羊膜炎组SAA与白细胞计数、CRP呈正相关,组内SAA水平的比较为：III级组>II级组>I级组。绒毛膜羊膜炎组的SAA、白细胞、CRP值高于非绒毛膜羊膜炎组及对照组,非绒毛膜羊膜炎组高于对照组。未足月胎膜早破合并绒毛膜羊膜炎患者各项指标的截断值为：白细胞计数13.28×109/L,CRP 14.28 mg/L,SAA 13.46 mg/L。三者ROC的曲线下面积分别为0.765、0.706、0.820,三者联合的曲线下面积0.830。结论: SAA与绒毛膜羊膜炎的严重程度成正比,对未足月胎膜早破合并绒毛膜羊膜炎的诊断价值优于白细胞计数和CRP,三者联合诊断价值更高。
Abstract
Objective To investigate the clinical value of serum amyloid A (SAA), white blood cell and C-reactive protein (CRP) in chorioamnionitis (CA) in preterm premature rupture of membranes (PPROM). Methods A total of 80 patients with premature rupture of membranes were selected from January 2020 to December 2021 in Zhuzhou Central Hospital. According to the results of placental disease after delivery, they were divided into chorioamniotic infection group (n= 35 cases, including 18 cases in grade I group, 10 cases in grade II group, 7 cases in grade III group) and non-chorioamniotic infection group (n=45 cases). Normal pregnant women were selected as control group (n=40 cases). The levels of serum amyloid A (SAA), white blood cells and C-reactive protein were measured in all pregnant women at admission. ROC curve was used to find the diagnostic value of each index in premature rupture of fetal membrane complicated with chorionic amniotitis. Results There was a positive correlation between SAA and white blood cell count and C-reactive protein in chorioamniotic infection group. The comparison of SAA level in the groups was as follows: Grade III group>Grade II group>Grade I group. The values of SAA, leukocyte and C-reactive protein in chorioamniotic group were higher than those in non-chorioamniotic group and control group, and the non-chorioamniotic group was higher than control group. The cut-off values of various indexes in patients with preterm premature rupture of membranes combined with chorioamnitis were as follows: leukocyte13.28×109/L, C-reactive protein 14.28mg/L, serum amyloid A 13.46mg/L. The area under the curve of ROC of the three are 0.765, 0.706 and 0.820 respectively, and the area under the curve of the three combined is 0.830. Conclusion SAA is in direct proportion to the severity of chorionic amniotitis. The diagnostic value of SAA in premature rupture of fetal membrane combined with chorionic amniotitis is better than that of leukocyte and C-reactive protein.
关键词
C反应蛋白 /
血清淀粉样蛋白A /
胎膜早破 /
绒毛膜羊膜炎
Key words
C-reactive protein /
serum amyloid A protein /
premature rupture of membranes /
chorioamnionitis
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参考文献
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基金
湖南省株洲市2022年度创新型城市建设专项社会化出资项目
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