白介素-1与β2防御素对胎膜早破合并羊膜腔感染预测的意义

摘要

目的：通过测定外周血白介素-1（IL-1）及β2防御素（HBD-2）水平，探讨他们在胎膜早破中的作用，分析其与羊膜腔感染的相关性，为临床的诊断与治疗提供新的思路。方法42例胎膜早破患者分别测定外周血 IL-1及HBD-2水平，与20例对照组进行比较，根据胎膜病理诊断结果，实验组进一步分出组织学绒毛膜炎组（HCA）和非组织学绒毛膜炎组（非 HCA 组），比较两组间 HBD-2及 IL-1水平。结果42名胎膜早破患者中，病理证实胎膜早破无感染者（非 HCA）24例，感染者（HCA）18例。HCA 组 IL-1水平与非 HCA 组比较，差异显著，P ＜0．01；HCA 组 IL-1水平与对照组比较，差异显著，P ＜0．01；非 HCA 组的 IL-1水 平 与 对 照 组 比 较，无显著性差异，P＞0．05。HCA 组HBD 水平与非 HCA 组比较，差异显著，P ＜0．05；HCA 组 HBD 水平与对照组比较，差异显著，P ＜0．01；非 HCA 组的 HBD 水平与对照组比较，无显著性差异，P＞0．05。从均数直观图观察到，随着胎膜早破的出现，感染的发生，IL-1、HBD 水平均有升高的趋势。通过 ROC 曲线观察，当 IL-1以80．22 pg／ml 为分界点时，诊断 HCA 的敏感性为0．78，特异性为0．75；当 HBD 以474．79 ng／L 为分界点时，诊断 HCA 的敏感性为0．67，特异性为0．79。结论胎膜早破患者外周血 IL-1、HBD-2水平有预测和诊断 HCA 的可能，其升高在 HCA 患者中有统计学意义，为临床 HCA 的诊断提供新的手段。%Objective To analysis the relationship between the infection and the serum level of IL-1 and HBD-2 in premature rupture of membranes.Methods 42 women with PROM were enrolled in the study.20 samples without PROM pregnancies matching the same gestational ages were recruited as control group.According to the results of pathological diagnosis of membranes,pregnant women with PROM were divided into histological chorioamnionitis (HCA)and non-HCA.We analyze the level of IL-1 and HBD-2 between the different groups.Results In 42 patients with PROM,24 cases were non-infected and 18 cases were infected.The level of IL-1 in HCA group are significantly higher than non-HCA group and control group(P <0.01).The level of HBD-2 in HCA group are significantly higher than non-HCA group(P <0.05)and control group(P < 0.01).There is no statistically significant different between non-HCA and control group(P >0.05).We observe from the mean plot show that the level of IL-1 and HBD-2 has a tendency to rise with the emergence of PROM and infection.According to the ROC curve,when IL-1 take 80.22 pg/mL,the sensitivity and specificity of diagnosis infection in PROM are 0.78 and 0.75 respectively.when HBD-2 take 474.79 ng/L,the sensitivity and specificity of diagnosis infection in PROM are 0.67 and 0.79 respectively.Conclusion The clinical value of serum IL-1 and HBD-2 may be a specific index diagnosis of infection PROM in the future.