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首页> 外文期刊>Balkan Medical Journal >Diagnostic and Prognostic Value of Presepsin for Subclinical Chorioamnionitis in Pregnancies between 23–28 Week with Preterm Premature Rupture of the Membranes
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Diagnostic and Prognostic Value of Presepsin for Subclinical Chorioamnionitis in Pregnancies between 23–28 Week with Preterm Premature Rupture of the Membranes

机译：胃蛋白酶在早产胎膜早破23-28周之间对亚临床绒毛膜羊膜炎的诊断和预后价值

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Background Presepsin is an inflammatory marker released from monocytes and macrophages as an acute reaction to microbial infection. We hypothesized that it may be useful in pregnancies with preterm premature rupture of the membranes (PPROM) for early diagnosis of subclinical chorioamnionitis. Aims To determine whether the plasma presepsin level has any diagnostic or prognostic value for subclinical chorioamnionitis in pregnancies complicated with PPROM. Study Design Prospective cohort study. Methods Fifty-three singleton pregnancies between 23 and 28 weeks of gestation diagnosed with PPROM were prospectively included in the study. Venous blood samples were collected at admission, at the 48th hour of admission, and at the time of delivery to determine presepsin and C-reactive Protein (CRP) levels and white blood cell (WBC) counts. Chorioamnionitis was diagnosed by microscopic examination of the placenta and cords. Results Of the 53 PPROM cases included in the study, 41 (77.4%) had histologically confirmed chorioamnionitis. Neonatal sepsis developed in 24 (45.3%) of the newborns. The median presepsin level at admission was 135.0 pg/mL for pregnancies with subclinical chorioamnionitis and 113.5pg/mL for pregnancies without chorioamnionitis (p=0.573). There was also no significant difference between subclinical chorioamnionitis (+) and (?) cases in terms presepsin levels at the 48th hour and at delivery. However, chorioamnionitis (+) cases showed a significant decrease in both presepsin level and WBC count at the 48th hour after the administration of antibiotics, which increased significantly at delivery (p0.001 and p=0.011, respectively). Conclusion The striking fluctuations in presepsin level after the diagnosis of PPROM can be used to predict subclinical chorioamnionitis and determine the optimal timing of delivery before the clinical signs of chorioamnionitis are established. However, presepsin level itself was neither diagnostic nor prognostic for neonatal sepsis.
机译：背景葡萄球菌蛋白酶是从单核细胞和巨噬细胞释放的炎性标志物，是对微生物感染的急性反应。我们假设它可能在早产胎膜早破（PPROM）的妊娠中用于亚临床绒毛膜羊膜炎的早期诊断。目的确定在妊娠合并PPROM的亚临床绒毛膜羊膜炎血浆血浆中的胃蛋白酶水平是否具有诊断或预后价值。研究设计前瞻性队列研究。方法前瞻性纳入PPROM诊断为妊娠23至28周的53例单胎妊娠。在入院时，入院第48小时和分娩时收集静脉血样品，以确定前蛋白酶和C反应蛋白（CRP）水平以及白细胞（WBC）计数。通过显微镜检查胎盘和脐带诊断出绒毛膜羊膜炎。结果在研究中包括的53例PPROM病例中，有41例（77.4％）具有组织学证实的绒毛膜羊膜炎。新生儿败血症在24个新生儿中占45.3％。患有亚临床绒毛膜羊膜炎的孕妇入院时的中环肽酶水平为135.0 pg / mL，而不含绒毛膜羊膜炎的孕妇的入院前血清蛋白酶水平为113.5pg / mL（p = 0.573）。亚临床绒毛膜羊膜炎（+）和（？）病例在第48小时和分娩时的胃蛋白酶水平之间也没有显着差异。但是，绒毛膜羊膜炎（+）病例在服用抗生​​素后第48小时，其胃蛋白酶和WBC计数均显着下降，分娩时显着上升（分别为p <0.001和p = 0.011）。结论PPROM诊断后的前体蛋白酶水平显着波动可用于预测亚临床绒毛膜羊膜炎，并在确定绒毛膜羊膜炎的临床症状之前确定最佳分娩时机。然而，葡萄球菌蛋白酶水平本身对新生儿败血症既没有诊断也没有预后。

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