Evans M I, Hajj S N, Devoe L D, Angerman N S, Moawad A H
Am J Obstet Gynecol. 1980 Nov 15;138(6):648-52. doi: 10.1016/0002-9378(80)90082-4.
The management of patients with premature rupture of membranes (PROM) poses one of the most serious dilemmas in obstetrics since PROM significantly increases the likelihood of prematurity and serious perinatal infection. Early infection is not reliably predicted nor detected by standard laboratory parameters. Serum C-reactive protein (CRP) levels were assayed along with white blood cell count, differential, and temperature course in patients with PROM and controls. Elevated CRP very accurately divided patients with evidence of infectious morbidity from those without such evidence (p < 0.001). In 109 patients there were 11 false negatives and no false positives. In 14 of 20 patients followed with serial comparisons who developed morbidity, CRP became elevated at least 12 hours prior to any other parameter measured. Changes in the other six patients were concurrent. The results suggest that CRP may be a reliable, early predictor of infectious morbidity and thus may be of benefit in the selective management of patients with PROM.
胎膜早破（PROM）患者的管理是产科最严重的难题之一，因为胎膜早破会显著增加早产和严重围产期感染的可能性。早期感染无法通过标准实验室参数可靠地预测或检测出来。对胎膜早破患者和对照组测定了血清C反应蛋白（CRP）水平以及白细胞计数、分类和体温变化过程。CRP升高能非常准确地区分有感染性发病迹象的患者和无此迹象的患者（p < 0.001）。在109例患者中，有11例假阴性，无假阳性。在20例接受连续观察并发病的患者中，有14例CRP至少在测量的任何其他参数升高前12小时就已升高。其他6例患者的变化是同时出现的。结果表明，CRP可能是感染性发病的可靠早期预测指标，因此可能有助于对胎膜早破患者进行选择性管理。
