Murtha A P, Greig P C, Jimmerson C E, Roitman-Johnson B, Allen J, Herbert W N
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA.
Am J Obstet Gynecol. 1996 Oct;175(4 Pt 1):966-9. doi: 10.1016/s0002-9378(96)80033-0.
Our purpose was to determine whether maternal serum interleukin-6 concentrations are elevated in patients with preterm premature rupture of membranes and intrauterine infection.
By use of a sensitive enzyme-linked immunosorbent assay maternal serum interleukin-6 concentrations were measured in 110 samples from patients at 22 to 34 weeks gestation with the following conditions: nonlaboring, uninfected controls (n = 46), preterm premature rupture of membranes > 48 hours before delivery without infection (n = 27), preterm premature rupture of membranes 24 to 48 hours before delivery with subsequent clinical or histologic infection (n = 11), and preterm premature rupture of membranes < 24 hours before delivery with infection present by clinical or histologic criteria (n = 26). The Mann-Whitney U test was used for statistical analysis.
Compared with that of nonlaboring controls, serum interleukin-6 was significantly higher in patients with preterm premature rupture of membranes < 24 hours before delivery with evidence of infection (17.2 vs 1.6 pg/ml, p < 0.0001). Patients with preterm premature rupture of membranes 24 to 48 hours before delivery who had infection had significantly higher interleukin-6 concentrations than did nonlaboring controls (3.6 vs 1.6 pg/ml, p = 0.006). There was no significant difference in interleukin-6 concentrations in nonlaboring controls compared with patients with preterm premature rupture of membranes when serum was obtained > 48 hours before delivery (1.6 vs 1.6 pg/ml, p = 0.90). A serum interleukin-6 level > or = 8 pg/ml yielded a sensitivity of 81%, a specificity of 99%, a positive predictive value of 96%, and a negative predictive value of 95% for identifying intrauterine infection in patients with preterm premature rupture of membranes on the day of delivery.
Maternal serum interleukin-6 concentrations are elevated in patients with preterm premature rupture of membranes with clinical or histologic chorioamnionitis.
我们的目的是确定胎膜早破合并宫内感染患者的母血白细胞介素-6浓度是否升高。
采用灵敏的酶联免疫吸附测定法，对110例妊娠22至34周患者的母血白细胞介素-6浓度进行检测，这些患者有以下情况：未临产、未感染的对照组（n = 46）；分娩前胎膜早破超过48小时且无感染（n = 27）；分娩前24至48小时胎膜早破且随后有临床或组织学感染（n = 11）；分娩前24小时内胎膜早破且根据临床或组织学标准存在感染（n = 26）。采用Mann-Whitney U检验进行统计分析。
与未临产对照组相比，分娩前24小时内胎膜早破且有感染证据的患者血清白细胞介素-6显著升高（17.2对1.6 pg/ml，p < 0.0001）。分娩前24至48小时胎膜早破且有感染的患者白细胞介素-6浓度显著高于未临产对照组（3.6对1.6 pg/ml，p = 0.006）。在分娩前48小时以上采集血清时，未临产对照组与胎膜早破患者的白细胞介素-6浓度无显著差异（1.6对1.6 pg/ml，p = 0.90）。血清白细胞介素-6水平≥8 pg/ml对分娩当天胎膜早破患者宫内感染的诊断敏感性为81%，特异性为99%，阳性预测值为96%，阴性预测值为95%。
临床或组织学绒毛膜羊膜炎的胎膜早破患者母血白细胞介素-6浓度升高。
