Jung Eun Young, Park Kyo Hoon, Han Bo Ryoung, Cho Soo-Hyun, Ryu Aeli
1 Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
2 Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Reprod Sci. 2017 Jan;24(1):142-147. doi: 10.1177/1933719116651149. Epub 2016 Sep 27.
Cervicovaginal fluid (CVF) samples may be a feasible alternative to amniotic fluid (AF) sampling in women with preterm premature rupture of the membranes (PPROMs), because PPROM causes AF to spill into the CVF. We aimed to assess the correlation and limits of agreement of interleukin 8 (IL-8) levels between CVF and AF in women with PPROM and to compare the clinical value of CVF IL-8 to AF IL-8 for the prediction of microbial invasion of amniotic cavity (MIAC). A retrospective cohort observational study was conducted on 85 women with singleton pregnancies (24-34 weeks) presenting with PPROM. The CVF samples were obtained simultaneously with AF samples retrieved by transabdominal amniocentesis. The levels of IL-8 in paired CVF and AF samples were measured with enzyme-linked immunosorbent assay in the same plate in duplicate using the same dilutions. The prevalence of a positive AF culture was 40% (34 of 85). The CVF IL-8 levels were significantly and positively correlated with AF IL-8 levels ( r = 0.778). However, the level of agreement between CVF and AF IL-8 levels yielded a Cohen κ statistic of 0.276. Paired Student t test revealed that the difference between CVF and AF IL-8 levels was statistically significant. The area under the curve for AF IL-8 was significantly higher than that for CVF IL-8 ( P = .013). In women with PPROM, IL-8 levels in CVF were significantly correlated with, but were significantly different from, those in AF samples. The CVF IL-8 has moderate predictive capability for the risk of MIAC, but this is inferior to AF IL-8.
对于胎膜早破（PPROM）的女性，宫颈阴道液（CVF）样本可能是羊水（AF）采样的一种可行替代方法，因为PPROM会导致羊水漏入宫颈阴道液中。我们旨在评估PPROM女性宫颈阴道液和羊水中白细胞介素8（IL-8）水平的相关性及一致性界限，并比较宫颈阴道液IL-8与羊水IL-8对羊膜腔微生物入侵（MIAC）预测的临床价值。对85例单胎妊娠（24 - 34周）且发生PPROM的女性进行了一项回顾性队列观察研究。在经腹羊膜腔穿刺获取羊水样本的同时获取宫颈阴道液样本。配对的宫颈阴道液和羊水样本中的IL-8水平在同一板中使用相同稀释度进行双份酶联免疫吸附测定。羊水培养阳性的患病率为40%（85例中的34例）。宫颈阴道液IL-8水平与羊水IL-8水平显著正相关（r = 0.778）。然而，宫颈阴道液和羊水IL-8水平之间的一致性程度产生的Cohen κ统计量为0.276。配对t检验显示宫颈阴道液和羊水IL-8水平之间的差异具有统计学意义。羊水IL-8的曲线下面积显著高于宫颈阴道液IL-8（P = 0.013）。在PPROM女性中，宫颈阴道液中的IL-8水平与羊水样本中的水平显著相关，但差异显著。宫颈阴道液IL-8对MIAC风险具有中等预测能力，但不如羊水IL-8。
