TNF–α、MMP–8 与 HCG 联合检测对 胎膜早破患者宫内感染的预测价值

Predictive Value of Combined TNF-α, MMP-8 and HCG Testing for Intrauterine Infection in Patients with Premature Rupture of Membranes

摘要:

〔摘 要〕 目的：探讨血清肿瘤坏死因子 –α（TNF–α）、基质金属蛋白酶 8（MMP–8）与人绒毛促性腺激素（HCG） 联合检测在胎膜早破患者宫内感染中的预测价值。 方法：选取 2020 年 5 月至 2022 年 5 月赣州市人民医院收治的 61 例胎 膜早破产妇作为研究对象，根据是否发生宫内感染分为感染组 18 例和未感染组 43 例。分别比较感染组和未感染组患者之 间，感染组中的轻度感染和重度感染患者之间的血清 HCG、MMP–8、TNF–α 水平，并比较血清 HCG、MMP–8、TNF–α 对胎膜早破合并宫内感染的预测价值。 结果：感染组产妇血清 HCG、MMP–8、TNF–α 水平均高于未感染组，重度感染组 产妇 HCG、MMP–8、TNF–α 水平均高于轻度感染组，差异均具有统计学意义（P ＜ 0.05）。血清 HCG、MMP–8、TNF–α 三项联合检测的特异度为 83.72 %，灵敏度为 72.22 %，准确度为 80.32 %。 结论：对于胎膜早破孕妇，联合检测血清 HCG、MMP–8 和 TNF–α 检测可弥补 TNF–α、MMP–8 单一检测特异度低的缺点，更有效地预测宫内感染的风险；有助于 早期识别和处理胎膜早破合并宫内感染，从而降低相关并发症的发生率，改善妊娠结局。

关键词:宫内感染;胎膜早破;肿瘤坏死因子 –α;基质金属蛋白酶 8;人绒毛膜促性腺激素

Abstract:

〔Abstract〕 Objective To investigate the predictive value of serum tumour necrosis factor-α (TNF-α), matrix metalloproteinase 8 (MMP-8) and human chorionic gonadotropin (HCG) combined assay in intrauterine infections in patients with premature rupture of membranes. Methods Sixty-one cases of women with premature rupture of membranes admitted to Ganzhou People's Hospital from May 2020 to May 2022 were selected as the study subjects, and they were divided into 18 cases in the infected group and 43 cases in the uninfected group according to whether or not intrauterine infection occurred. Serum HCG, MMP-8, and TNF-α levels were compared between patients in the infected and uninfected groups, and between mildly infected and severely infected patients in the infected group, respectively, and the predictive value of serum HCG, MMP-8, and TNF-α for intrauterine infection combined with premature rupture of membranes was compared. Results The levels of serum HCG, MMP-8 and TNF-α in the infected group were higher than those in the aninfected group, and the levels of HCG, MMP-8 and TNF-α in the severely infected group were higher than those in the mildly infected group, with statistical significance (P < 0.05). The specificity, sensitivity and accuracy of serum HCG, MMP-8 and TNF-α were 83.72%, 72.22% and 80.32% respectively. Conclusion For pregnant women with premature rupture of membranes, the combined detection of serum HCG, MMP-8 and TNF-α can make up for the low specificity of the single detection of TNF-α and MMP-8, and predict the risk of intrauterine infection more effectively. It is helpful for early identification and treatment of premature rupture of membranes combined with intrauterine infection, so as to reduce the incidence of related complications and improve the pregnancy outcome.

Key words:Intrauterine infection; Premature rupture of membranes; Tumour necrosis factor-α; Matrix metalloproteinase-8; Human chorionic gonadotropin