Jun J K, Yoon B H, Romero R, Kim M, Moon J B, Ki S H, Park J S
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Am J Obstet Gynecol. 2000 Oct;183(4):868-73. doi: 10.1067/mob.2000.109034.
Our aim was to determine whether interleukin-6 concentrations in cervical fluid samples are of value in the identification of microbial invasion of the amniotic cavity, prediction of the duration of the latency period, and assessment of the risk of neonatal complications in preterm premature rupture of membranes.
A cohort study was performed in 86 patients with preterm premature rupture of membranes. Amniotic fluid and cervical fluid were collected. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Interleukin 6 was measured by a sensitive and specific immunoassay. The receiver operating characteristic curve, logistic regression, and survival techniques were used for analysis.
(1) Patients with a positive amniotic fluid culture had a significantly higher median cervical fluid interleukin 6 concentration than those with negative results (median, 528 pg/mL; range, 174-825 pg/mL; vs median, 169 pg/mL; range, 8-986 pg/mL; P <.0001). (2) A cervical fluid interleukin 6 concentration of >350 pg/mL had a sensitivity of 92% and a specificity of 78% in the identification of a positive amniotic fluid culture. (3) Patients with a cervical fluid interleukin 6 concentration of >350 pg/mL had a significantly shorter median interval to delivery and higher rate of funisitis, preterm delivery within 2 days and 7 days, and the occurrence of significant neonatal morbidity than did those with a cervical fluid interleukin 6 concentration of <350 pg/mL (P <.05 for each). (4) The increased perinatal morbidity remained significant after adjustment for gestational age (P <.05). (5) There was a strong correlation between cervical fluid concentrations and amniotic fluid concentrations of interleukin 6 (P <.001).
Cervical fluid interleukin 6 determinations are of value in the assessment of the likelihood of microbial invasion of the amniotic cavity, impending preterm delivery, and the occurrence of significant neonatal complications in the setting of preterm premature rupture of membranes.
我们的目的是确定宫颈液样本中的白细胞介素-6浓度在羊膜腔微生物入侵的识别、潜伏期持续时间的预测以及早产胎膜早破新生儿并发症风险评估方面是否具有价值。
对86例早产胎膜早破患者进行了一项队列研究。收集羊水和宫颈液。对羊水进行需氧菌、厌氧菌以及支原体培养。采用灵敏且特异的免疫测定法测量白细胞介素6。使用受试者工作特征曲线、逻辑回归和生存技术进行分析。
（1）羊水培养阳性的患者宫颈液白细胞介素6浓度中位数显著高于培养阴性的患者（中位数，528 pg/mL；范围，174 - 825 pg/mL；相比之下，中位数，169 pg/mL；范围，8 - 986 pg/mL；P <.0001）。（2）宫颈液白细胞介素6浓度>350 pg/mL在识别羊水培养阳性方面的敏感性为92%，特异性为78%。（3）宫颈液白细胞介素6浓度>350 pg/mL的患者分娩间隔中位数显著缩短，脐带炎、2天和7天内早产以及严重新生儿发病的发生率高于宫颈液白细胞介素6浓度<350 pg/mL的患者（每项P <.05）。（4）调整孕周后围产期发病率的增加仍然显著（P <.05）。（5）宫颈液白细胞介素6浓度与羊水白细胞介素6浓度之间存在强相关性（P <.001）。
宫颈液白细胞介素6测定在评估早产胎膜早破情况下羊膜腔微生物入侵的可能性、即将发生的早产以及严重新生儿并发症的发生方面具有价值。
