中性粒细胞-淋巴细胞比值预测未足月胎膜早破合并病理性羊水的病例对照研究。
Neutrophil-lymphocyte ratio for the prediction of histological chorioamnionitis in cases of preterm premature rupture of membranes: a case-control study.
机构信息
Clinic of Obstetrics, and Gynecology, Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, M.K. Ciurlionio st. 21, 03101, Vilnius, Lithuania.
Center of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, Santariskiu st. 2, 08661, Vilnius, Lithuania.
出版信息
BMC Pregnancy Childbirth. 2021 Sep 27;21(1):656. doi: 10.1186/s12884-021-04101-z.
BACKGROUND
The neutrophil-lymphocyte ratio (NLR) is easily calculated blood test parameter, which can be used as marker to predict many inflammatory disorders. The aim of this study was to assess and compare the NLR in maternal blood with the white blood cell (WBC) count and C-reactive protein (CRP) concentration for the prediction of histological chorioamnionitis.
METHODS
This was a case-control study of 137 woman with preterm premature rupture of membranes (PPROM) at a gestational age between 22 and 34 weeks. Blood samples, collected less than 48 h before delivery and at least 48 h after the administration of corticosteroids, were selected for the analysis. The NLR was calculated by dividing the number of neutrophils by the number of lymphocytes. Chorioamnionitis was diagnosed by the histopathological evaluation of placental membranes and chorionic plate.
RESULTS
Patients with diagnosed histological chorioamnionitis (HCA) had significantly higher levels of WBC, CRP and NLR (p-value < 0.001). Levels of WBC, CRP and NLR predicted HCA with an area under the curve (AUC) of 0.81, 0.81 and 0.89, respectively. NLR had statistically significantly higher AUC than WBC, but no significant difference was found between AUCs of NLR and CRP. The cut-off level of NLR was found to be 5,97, which had a sensitivity of 77 % and a specificity of 95 %.
CONCLUSION
NLR has a good predictive value for HCA and could be used as an additional diagnostic marker for predicting histological chorioamnionitis in cases with preterm premature rupture of membranes before 34 weeks of gestation.
背景
中性粒细胞与淋巴细胞比值（NLR）是一种易于计算的血液检测参数，可作为预测多种炎症性疾病的标志物。本研究旨在评估和比较母体血液中的 NLR 与白细胞计数（WBC）和 C 反应蛋白（CRP）浓度，以预测组织学绒毛膜羊膜炎。
方法
这是一项 137 例在妊娠 22 至 34 周之间发生早产胎膜早破（PPROM）的病例对照研究。选择在分娩前 48 小时内和皮质类固醇给药后至少 48 小时采集的血液样本进行分析。NLR 通过将中性粒细胞数量除以淋巴细胞数量计算得出。通过对胎盘膜和绒毛板的组织病理学评估诊断绒毛膜羊膜炎。
结果
诊断为组织学绒毛膜羊膜炎（HCA）的患者的 WBC、CRP 和 NLR 水平明显更高（p 值<0.001）。WBC、CRP 和 NLR 水平预测 HCA 的曲线下面积（AUC）分别为 0.81、0.81 和 0.89。NLR 的 AUC 显著高于 WBC，但 NLR 和 CRP 的 AUC 之间无显著差异。NLR 的截断值为 5.97，其灵敏度为 77%，特异性为 95%。
结论
NLR 对 HCA 具有良好的预测价值，可作为预测妊娠 34 周前早产胎膜早破患者组织学绒毛膜羊膜炎的附加诊断标志物。
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