末梢全血C-反应蛋白定量测定在急性绒毛膜羊膜炎诊断中的应用价值

目的探讨末梢全血C-反应蛋白(CRP)测定在诊断急性绒毛膜羊膜炎的应用价值。方法随机选取2009年1月至2011年6月濮阳市妇幼保健院收治的单胎早产孕妇,根据分娩后胎盘组织学检查结果,存在急性绒毛膜羊膜炎者210例列入对照组,无炎性反应60例列入健康对照组。210例产妇羊水浑浊、胎盘的胎儿面明显颜色发暗以及表面呈黄绿色、有异味的立即测定其产妇及新生儿末梢全血CRP及白细胞(WBC),并在抗生素治疗3d后再次测定末梢全血CRP浓度。以60例胎盘健康无异常的产妇生产时常规检查产妇及新生儿为对照。结果经过组织学检查诊断证实为急性绒毛膜羊膜炎的CRP测定值均明显升高,与60例健康对照组之比t检验差异有统计学意义(P<0.05),对CRP升高的产妇及新生儿进行抗生素治疗3d后,末梢全血CRP的测定浓度明显下降,与用抗生素前相比,t检验差异有统计学意义。结论末梢全血CRP测定不仅仅常用于儿童急性感染、新生儿败血症等,也适用于孕产妇的上行感染,是诊断产妇急性绒毛膜羊膜炎的重要指标之一,在组织病理学检查的同时,可以尽早地进行CRP定量监测,以减少感染引起的母婴并发症。

Application value of peripheral blood CRP quantitative determination in acute chorioamnionitis

Objective To investigate the application value of peripheral whole blood C-reaction protein（CRP） measurement in the diagnosis of acute chorioamnionitis. Methods Singleton premature delivery pregnant women were randomly selected in our hospital from January 2009 to June 2011 and divided into the control group（acute cho- rioamnionitis, 210 cases） and the normal control group（without inflammatory manifestations, 60 cases） according to the placenta histological examination results after delivery. In 210 puerperas,if amniotic fluid was turbid, color in the fetal side of the placenta was obviously dark and the surface was turned into dark yellow-green with peculiar smell, maternal and neonatal peripheral blood CRP and WBC were immediately detected. After 3 d antibiotic treatment,pe- ripheral CRP was redetected. The routine examination in 60 pueperas with normal placentas and neonates were as the control. Results The CRP values in acute chorioamnionitis confirmed by histological examination was significantly increased compared with that in 60 cases of normal control, showing statistical difference in t-test （P~0.05）. After 3 d antibiotic treatment in puerperas and neonates with increased CRP, peripheral CRP levels were obviously decreased with statistical difference between before and after treatment in test. Conclusion The peripheral blood CRP measure- ment is not only commonly used in children with acute infections, neonatal sepsis, but also is suitable for ascending in- fection in pregnant women and puerperas,which is one of important indicators for diagnosing acute chorioamnionitis. Performing the histopathological examination, simultaneous quantitative monitoring of CRP could be carried out as soon as possible to reduce the complications of maternal and neonates caused by infections.