外周血IL-6与IL-8联合检测诊断宫内感染的效果
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摘要
目的探讨外周血白细胞介素-6(IL-6)和IL-8联合检测在诊断宫内感染中的效果。方法选择医院2011年9月-2015年1月孕妇足月住院发生胎膜早破(Premature Rrupture of Mmembranes,PROM)患者60例为研究对象,根据宫内感染情况,分为PROM感染组21例和PROM未感染组39例,抽取外周静脉血或羊水测定IL-6、IL-8水平,选取同期产检的足月孕妇60例为对照组,分析外周血IL-6、IL-8水平与PROM绒毛膜羊膜炎的关系。结果 PROM感染组患者外周静脉血和羊水IL-6和IL-8分别为(532.16±93.29)pg/ml、(567.84±134.15)pg/ml和(781.25±124.05)pg/ml、(794.63±118.64)pg/ml均高于PROM未感染组(297.81±86.39)pg/ml、(304.56±98.67)pg/ml和(562.37±105.82)pg/ml、(589.32±124.55)pg/ml和对照组(P<0.05);重度感染患者外周静脉血和羊水IL-6和IL-8分别为(641.59±104.25)pg/ml、(689.35±114.02)pg/ml和(849.63±130.47)pg/ml、(889.72±110.91)pg/ml高于中度感染和轻度感染患者(P<0.05);随着PROM感染组患者治疗时间的延长,外周静脉血IL-6、IL-8水平呈逐渐降低的趋势(P<0.05);IL-6和IL-8联合检测在敏感度、特异度、阳性预测值、阴性预测值方面均有优势。结论外周血IL-6、IL-8水平可作为PROM宫内感染的诊断及评估严重程度的重要指标,二者联合检测对于预测PROM宫内感染,具有灵敏度和特异度高的优点。
OBJECTIVE To investigate the effect of combined detection of interleukin-6(IL-6)and interleukin-8(IL-8)in the diagnosis of intrauterine infection.METHODS A total of 60 patients of full-term premature rupture of membranes(premature rupture of membranes,PROM)in our hospital from Sept.2011 to Jan.2015 were selected,and were randomly divided into PROM infection group(21 cases)and PROM uninfected group(39 cases)according to the intrauterine infection situation,IL-6 and IL-8 levels were taken from venous blood or amniotic fluid for determination,and 60 cases of full-term pregnant women with outpatient regular antenatal examination were set as control group.The relationships between IL-6 and IL-8 levels in peripheral blood and PROM chorioamnionitis were analyzed.RESULTS Levels of IL-6 and IL-8 from peripheral venous blood and amniotic fluid in the PROM infection group were(532.16±93.29)pg/mL,(567.84±134.15)pg/mL and(781.25±124.05)pg/mL,(794.63±118.64)pg/mL,respectively,which were significantly higher than(297.81±86.39)pg/mL,(304.56±98.67)pg/mL and(562.37±105.82)pg/mL,(589.32±124.55)pg/mL in the PROM uninfected group and the control group(P<0.05).Levels of IL-6 and IL-8 in peripheral venous blood and amniotic fluid in severe infection group were(641.59±104.25)pg/mL,(689.35±114.02)pg/mL and(849.63±130.47)pg/mL,(889.72±110.91)pg/mL,which were significantly higher than those in moderate infection group and mild infection group(P<0.05).With the extension of treatment time in patients with PROM infection,the levels of IL-6 and IL-8 in peripheral venous blood were gradually decreased(P<0.05).The combined detection of IL-6 and IL-8 had advantages in sensitivity,specificity,positive predictive value and negative predictive value.CONCLUSIONLevels of IL-6 and IL-8 in peripheral blood can be used as an important index for diagnosis and evaluation of he severity of PROM intrauterine infection,and the combined detection of IL-6 and IL-8 has high sensitivity and specificity for prediction of PROM intrauterine infection.
OBJECTIVE To investigate the effect of combined detection of interleukin-6(IL-6)and interleukin-8(IL-8)in the diagnosis of intrauterine infection.METHODS A total of 60 patients of full-term premature rupture of membranes(premature rupture of membranes,PROM)in our hospital from Sept.2011 to Jan.2015 were selected,and were randomly divided into PROM infection group(21 cases)and PROM uninfected group(39 cases)according to the intrauterine infection situation,IL-6 and IL-8 levels were taken from venous blood or amniotic fluid for determination,and 60 cases of full-term pregnant women with outpatient regular antenatal examination were set as control group.The relationships between IL-6 and IL-8 levels in peripheral blood and PROM chorioamnionitis were analyzed.RESULTS Levels of IL-6 and IL-8 from peripheral venous blood and amniotic fluid in the PROM infection group were(532.16±93.29)pg/mL,(567.84±134.15)pg/mL and(781.25±124.05)pg/mL,(794.63±118.64)pg/mL,respectively,which were significantly higher than(297.81±86.39)pg/mL,(304.56±98.67)pg/mL and(562.37±105.82)pg/mL,(589.32±124.55)pg/mL in the PROM uninfected group and the control group(P<0.05).Levels of IL-6 and IL-8 in peripheral venous blood and amniotic fluid in severe infection group were(641.59±104.25)pg/mL,(689.35±114.02)pg/mL and(849.63±130.47)pg/mL,(889.72±110.91)pg/mL,which were significantly higher than those in moderate infection group and mild infection group(P<0.05).With the extension of treatment time in patients with PROM infection,the levels of IL-6 and IL-8 in peripheral venous blood were gradually decreased(P<0.05).The combined detection of IL-6 and IL-8 had advantages in sensitivity,specificity,positive predictive value and negative predictive value.CONCLUSIONLevels of IL-6 and IL-8 in peripheral blood can be used as an important index for diagnosis and evaluation of he severity of PROM intrauterine infection,and the combined detection of IL-6 and IL-8 has high sensitivity and specificity for prediction of PROM intrauterine infection.
引文
[1]Armstrong-Wells J,Donnelly M,Post MD,et al.Inflammatory predictors of neurologic disability after preterm premature rupture of membranes[J].Am J Obstet Gynecol,2015,212(2):212.e1-9.
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[3]杨碧玉,张国琼.C反应蛋白白细胞介素-6及白细胞计数在足月胎膜早破宫内感染中的意义[J].河北医学,2016,22(2):264-266.
[4]Aisiku IP,Yamal JM,Doshi P,et al.Plasma cytokines IL-6,IL-8,and IL-10are associated with the development of acute respiratory distress syndrome in patients with severe traumatic brain injury[J].Crit Care,2016,20(1):288.
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[6]田丰,王冀康,王新彩,等.血清IL-6和IL-8与TNF-α联合检测在胎膜早破早期宫内感染预测中的价值研究[J].中华医院感染学杂志,2017,27(5):1171-1174.
[7]李凯霞,刘福民.Toll受体4的表达与胎膜早破患者绒毛膜羊膜炎的关系探讨[J].中外医疗,2015,34(19):1-2.
[8]余蓓蓓,肖冰,王慧,等.胎膜早破后羊水残余量与宫内感染和新生儿发病率的相关性分析[J].现代生物医学进展,2013,13(34):6729-6732.
[9]Wang F,Wang Y,Wang R,et al.Predictive value of maternal serum NF-κB p65and sTREM-1for subclinical chorioamnionitis in premature rupture of membranes[J].Am J Reprod Immunol,2016,76(3):217-223.
[10]Zhang H,Wang LU,Wang J,et al.Premature rupture of the fetal membrane combined with subclinical chorioamnionitis negatively affects pregnancy outcomes by a mechanism associated with reduced levels of matrix metalloproteinase-2[J].Exp Ther Med,2015,10(2):561-566.
[11]Rojas JM,Arán-Sekul T,Cortés E,et al.Phospholipase D from loxosceles laeta spider venom induces IL-6,IL-8,CXCL1/GRO-α,and CCL2/MCP-1production in human skin fibroblasts and stimulates monocytes migration[J].Toxins(Basel),2017,9(4).pii:E125.
[12]狄君平,郑美云,吴婷婷.多项血清因子联合检测在胎膜早破早期宫内感染预测中的意义[J].中华医院感染学杂志,2011,21(11):2375-2377.
[13]Wickstr9m K,Stavréus-Evers A,Vercauteren O,et al.Effect of lignocaine on IL-6,IL-8,and MCP-1in peritoneal macrophages and endometriotic stromal cells[J].Reprod Sci,2017,24(3):382-392.
[14]彭凤梅.Hs-CRP、CRP预测胎膜早破早产儿宫内感染的价值及菌群分布情况研究[J].中国妇幼保健,2015,30(24):4149-4152.
[15]Mendieta D,De la Cruz-Aguilera DL,Barrera-Villalpando MI,et al.IL-8and IL-6primarily mediate the inflammatory response in fibromyalgia patients[J].J Neuroimmunol,2016,290:22-25.
[16]Yoshio T,Okamoto H,Kurasawa K,et al.IL-6,IL-8,IP-10,MCP-1and G-CSF are significantly increased in cerebrospinal fluid but not in sera of patients with central neuropsychiatric lupus erythematosus[J].Lupus,2016,25(9):997-1003.
[17]Kemp MW,Molloy TJ,Usuda H,et al.Outside-in acute fetal systemic inflammation in very preterm chronically catheterized sheep fetuses is not driven by cells in the fetal blood[J].Am J Obstet Gynecol,2016,214(2):281.e1-281.
[18]李红霞.血清β-hCG与CRP水平在预测胎膜早破宫内感染及预后的应用比较[J].中华医院感染学杂志,2012,22(10):2106-2108.
[2]Cabrera IB,Qui1ones JN,Durie D,et al.Use of intracervical balloons and chorioamnionitis in term premature rupture of membranes[J].J Matern Fetal Neonatal Med,2016,29(6):967-971.
[3]杨碧玉,张国琼.C反应蛋白白细胞介素-6及白细胞计数在足月胎膜早破宫内感染中的意义[J].河北医学,2016,22(2):264-266.
[4]Aisiku IP,Yamal JM,Doshi P,et al.Plasma cytokines IL-6,IL-8,and IL-10are associated with the development of acute respiratory distress syndrome in patients with severe traumatic brain injury[J].Crit Care,2016,20(1):288.
[5]时春艳,漆洪波,杨慧霞.胎膜早破的诊断与处理指南(2015)[J].中华妇产科杂志,2015,50(1):161-167.
[6]田丰,王冀康,王新彩,等.血清IL-6和IL-8与TNF-α联合检测在胎膜早破早期宫内感染预测中的价值研究[J].中华医院感染学杂志,2017,27(5):1171-1174.
[7]李凯霞,刘福民.Toll受体4的表达与胎膜早破患者绒毛膜羊膜炎的关系探讨[J].中外医疗,2015,34(19):1-2.
[8]余蓓蓓,肖冰,王慧,等.胎膜早破后羊水残余量与宫内感染和新生儿发病率的相关性分析[J].现代生物医学进展,2013,13(34):6729-6732.
[9]Wang F,Wang Y,Wang R,et al.Predictive value of maternal serum NF-κB p65and sTREM-1for subclinical chorioamnionitis in premature rupture of membranes[J].Am J Reprod Immunol,2016,76(3):217-223.
[10]Zhang H,Wang LU,Wang J,et al.Premature rupture of the fetal membrane combined with subclinical chorioamnionitis negatively affects pregnancy outcomes by a mechanism associated with reduced levels of matrix metalloproteinase-2[J].Exp Ther Med,2015,10(2):561-566.
[11]Rojas JM,Arán-Sekul T,Cortés E,et al.Phospholipase D from loxosceles laeta spider venom induces IL-6,IL-8,CXCL1/GRO-α,and CCL2/MCP-1production in human skin fibroblasts and stimulates monocytes migration[J].Toxins(Basel),2017,9(4).pii:E125.
[12]狄君平,郑美云,吴婷婷.多项血清因子联合检测在胎膜早破早期宫内感染预测中的意义[J].中华医院感染学杂志,2011,21(11):2375-2377.
[13]Wickstr9m K,Stavréus-Evers A,Vercauteren O,et al.Effect of lignocaine on IL-6,IL-8,and MCP-1in peritoneal macrophages and endometriotic stromal cells[J].Reprod Sci,2017,24(3):382-392.
[14]彭凤梅.Hs-CRP、CRP预测胎膜早破早产儿宫内感染的价值及菌群分布情况研究[J].中国妇幼保健,2015,30(24):4149-4152.
[15]Mendieta D,De la Cruz-Aguilera DL,Barrera-Villalpando MI,et al.IL-8and IL-6primarily mediate the inflammatory response in fibromyalgia patients[J].J Neuroimmunol,2016,290:22-25.
[16]Yoshio T,Okamoto H,Kurasawa K,et al.IL-6,IL-8,IP-10,MCP-1and G-CSF are significantly increased in cerebrospinal fluid but not in sera of patients with central neuropsychiatric lupus erythematosus[J].Lupus,2016,25(9):997-1003.
[17]Kemp MW,Molloy TJ,Usuda H,et al.Outside-in acute fetal systemic inflammation in very preterm chronically catheterized sheep fetuses is not driven by cells in the fetal blood[J].Am J Obstet Gynecol,2016,214(2):281.e1-281.
[18]李红霞.血清β-hCG与CRP水平在预测胎膜早破宫内感染及预后的应用比较[J].中华医院感染学杂志,2012,22(10):2106-2108.