Ismail M A, Zinaman M J, Lowensohn R I, Moawad A H
Am J Obstet Gynecol. 1985 Feb 15;151(4):541-4. doi: 10.1016/0002-9378(85)90285-6.
In a prospective study of 100 patients with preterm premature rupture of membranes, clinical chorioamnionitis was present in 18 and histologic chorioamnionitis was present in 63. Patients who were managed conservatively for premature rupture of membranes were monitored by C-reactive protein determination, white blood cell and differential counts, maternal temperature, and fetal heart tone. C-reactive protein was measured nephelometrically (Immuno-chemistry Analyzer II, Beckman). Elevated C-reactive protein levels correlated well with both the pathologic and the clinical diagnosis of chorioamnionitis. Elevated C-reactive protein levels (at least 12 to 24 hours before delivery) were more sensitive than other standard laboratory or clinical tests in predicting chorioamnionitis both by clinical and pathologic criteria. When C-reactive protein values were normal, clinical chorioamnionitis was rarely found, whereas pathologically diagnosed chorioamnionitis was found half of the time. We conclude that although the C-reactive protein level is a very sensitive predictor of infectious morbidity in premature rupture of membranes, its specificity is not high.
在一项对100例胎膜早破患者的前瞻性研究中，18例存在临床绒毛膜羊膜炎，63例存在组织学绒毛膜羊膜炎。对胎膜早破进行保守治疗的患者通过测定C反应蛋白、白细胞及分类计数、母体体温和胎儿心音进行监测。C反应蛋白采用比浊法测定（贝克曼免疫化学分析仪II）。C反应蛋白水平升高与绒毛膜羊膜炎的病理诊断和临床诊断均密切相关。在预测绒毛膜羊膜炎方面，C反应蛋白水平升高（至少在分娩前12至24小时）比其他标准实验室检查或临床检查在临床和病理标准上都更敏感。当C反应蛋白值正常时，很少发现临床绒毛膜羊膜炎，而病理诊断的绒毛膜羊膜炎有一半的发生率。我们得出结论，虽然C反应蛋白水平是胎膜早破感染性发病的非常敏感的预测指标，但其特异性不高。
