【摘要】 目的评价羊水(AF)基质金属蛋白酶-9(MMP-9)和白细胞介素-6(IL-6)在预测羊膜腔感染中的作用。方法收集有早产、胎膜早破或临床怀疑羊膜腔感染的单胎妊娠妇女84例,经腹壁羊膜穿刺抽取羊水。AF细菌培养阳性为羊膜腔感染。测定AF中的葡萄糖(Glu),白细胞,MMP-9和IL-6。结果羊膜腔感染患者AFMMP-9和IL-6水平明显升高。且MMP-9水平与IL-6密切相关(r=0.813,P<0.01)。AFMMP-9和IL-6又与白细胞呈正相关,而与AFGlu呈负相关。将MMP-9临界值定为13.6ng/mL,则其敏感度、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为77%,98%,98%和89%。若将IL-6临界值定为8.6ng/mL,则其敏感度、特异性、PPV和NPV分别为73%,78%,60%和86%。联合检测AFMMP-9和IL-6可提高羊膜腔感染诊断的敏感度和NPV。结论羊膜腔感染患者AFMMP-9和IL-6表达水平明显升高。为预测羊膜腔感染,MMP-9比IL-6为更准确。更多还原

【Abstract】 Objective To assess the role of matrix metalloproteinase-9(MMP-9) and interleukin-6 (IL-6) of amniotic fluid (AF) in predicting infection of amniotic cavity. Methods Eighty-four cases of sigle foetus women with premature delivery, premature rupture of foetal membranes,or suspicious infection of amnitotic cavity were enrolled in this study. AF was obtained by transabdominal amniocentesis before starting any treatment.Infection of amniotic cavity was defined when AF bacterial culture was positive. The contents of glucose, leukocytes, MMP-9,and IF-6 in AF were determined. Results The levels of MMP-9 and IL-6 in AF were significantly higher in women with infection of amniotic cavity than those in women without. In women with infection of amniotic cavity, MMP-9 level was significantly correlated with IL-6 level (r=0.813,P<0.01). The levels of both MMP-9 and IL-6 were positively correlated with leukocytes count, and negatively correlated with glucose concentration. Using 13.6 ng/mL MMP-9 and 8.6 ng/mL IL-6 as AF critical levels,the sensitivity,specificity,and positive and negative predictive values for diagnosing infection of amniotic cavity were 77% vs 73%,98% vs 78%,98% vs 60%,and 89% vs 86%,respectively. Combination detection of MMP-9 and IL-6 could improve the sensitivity and negative predictive value for diagnosing infection of amniotic cavity. Conclusion The levels of both AF MMP-9 and IL-6 significantly increased in women with infection of amniotic cavity. AF MMP-9 was a more accurate biochemical marker in predicting infection of amniotic cavity as with compared with IL-6.更多还原