实用临床医药杂志2025，Vol.29Issue(23)：36-41,47,7.DOI:10.7619/jcmp.20254940
未足月胎膜早破患者发生组织学绒毛膜羊膜炎的危险因素分析
Analysis of risk factors for histologic chorioamnionitis in patients with preterm premature rupture of membranes
摘要
Abstract
Objective To explore the risk factors for histologic chorioamnionitis(HCA)in patients with preterm premature rupture of membranes(PPROM)based on clinical characteristics and inflammatory indicators.Methods A retrospective analysis was conducted on the clinical data of 108 patients with PPROM.According to the postpartum pathological results,they were divided into HCA group(32 cases)and non-HCA group(76 cases).The clinical characteristics and laboratory indica-tor levels of the two groups were compared.Logistic regression analysis was used to screen the risk factors for HCA in patients with PPROM.Receiver operating characteristic(ROC)curves were plot-ted to analyze the predictive efficacy of independent risk factors and a combined model for the occur-rence of HCA in patientswith PPROM.Results The gestational age at membrane rupture in the HCA group was shorter than that in the non-HCA group.The proportions of patients with a rupture-to-deliv-ery interval≥24 h,concurrent vaginal infection,prenatal fever,positive group B Streptococcus(GBS),and severe amniotic fluid contamination were all higher in the HCA group than those in the non-HCA group.The levels of C-reactive protein(CRP),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and monocyte-to-lymphocyte ratio(MLR)were all higher in the HCA group than in the non-HCA group,with statistically significant differences(P＜0.05).The results of multivariate Logistic regression analysis showed that a rupture-to-delivery interval ≥24 h,prenatal fever,and an elevated NLR were independent risk factors for the occurrence of HCA in pa-tients with PPROM(P＜0.05).The ROC curves showed that the areas under the curves(AUC)for predicting the occurrence of HCA in patients with PPROM by rupture-to-delivery interval,prenatal fever,and NLR were 0.817,0.735,and 0.840,respectively,with sensitivities of 75.00％,71.88％,and 84.38％,respectively.The AUC predicted by the combined model was 0.906,with a sensitivi-ty of 86.80％,and its predictive efficacy was significantly better than that of individual indicator(P＜0.05).Conclusion A rupture-to-delivery interval ≥24 h,prenatal fever,and an elevated NLR are independent risk factors for the occurrence of HCA in patients with PPROM.Clinically,these indicators can be monitored to early identify the risk of HCA occurrence,thereby guiding the use of antimicrobial agents or the selection of the delivery timing.关键词
未足月胎膜早破/早产/组织学绒毛膜羊膜炎/中性粒细胞与淋巴细胞比值/血小板与淋巴细胞比值/单核细胞与淋巴细胞比值/产前发热/羊水污染Key words
preterm premature rupture of membranes/preterm birth/histologic chorioamnio-nitis/neutrophil-to-lymphocyte ratio/platelet-to-lymphocyte ratio/monocyte-to-lymphocyte ratio/prenatal fever/amniotic fluid contamination分类
医药卫生引用本文复制引用
凡秀丽,侯文汇..未足月胎膜早破患者发生组织学绒毛膜羊膜炎的危险因素分析[J].实用临床医药杂志,2025,29(23):36-41,47,7.基金项目
国家自然科学基金项目(82101744) （82101744）
河南省医学科技攻关计划联合共建项目(LHGJ20200317) （LHGJ20200317）
