救援性宫颈环扎术前中性粒细胞/淋巴细胞比值对潜在组织绒毛膜羊膜炎的预测价值

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Abstract

Objective To investigate whether the preoperative peripheral blood neutrophil/lymphocyte ratio (NLR) of pregnant women with acute cervical insufficiency can predict potential histologic chorioamnionitis (HCA). Methods A retrospective analysis was performed on the clinical data of 98 preterm pregnant women who underwent salvage cervical cyclization in Maternal and Child Health Hospital of Fujian Province from January 2016 to December 2020.According to the pathological results of placenta after delivery, they were divided into preterm with HCA group (63 cases) and preterm without HCA group (35 cases).Preoperative peripheral blood inflammation markers and positive rate of cervical secretion culture were compared between the two groups.ROC curve analysis of NLR was conducted to analyze its predictive value to HCA. Results The gestational age of premature rupture of membranes and the gestational age of delivery in preterm with HCA group were lower than those in preterm labor without HCA group, the pregnancy extension days were shorter than those in preterm without HCA group, and the cesarean section rate and neonatal weight were lower than those in preterm without HCA group, the differences were statistically significant (P＜0.05).The positive rate of NLR and cervix microbial culture in preterm with HCA group were higher than those in preterm labor without HCA group, the differences were statistically significant (P＜0.05).ROC curve analysis showed that THE AUC of NLR was 0.726 (P＜0.05), and the optimal cutoff value was 5.61.The sensitivity, specificity, positive predictive value and negative predictive value of NLR were 69.84%, 57.78%, 83.02% and 42.22%, respectively.Kaplan-Meier survival analysis showed that the median length of pregnancy prolonged after cervical cyclization was 53 days in the NLR≥5.61 group, and 63 days in the NLR ＜5.61 group, the difference was statistically significant (P＜0.05). Conclusion Maternal peripheral blood NLR is expected to be an inflammatory marker for predicting potential placental chorioamnionitis in pregnant women with acute cervical insufficiency, and is related to the prolongation of gestational week after rescue cervical cerclage.

Key words： Histologic chorioamnionitis Neutrophil to lymphocyte ratio Cervical insufficiency Rescue cervical cerclage

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	LI Li
	PAN Mian
	HUANG Xinxin
	ZHANG Jun
	YANG Danlin

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LI Li,PAN Mian,HUANG Xinxin, et al. Predictive value of neutrophil/lymphocyte ratio for potential histologic chorioamnionitis before rescue cervical cerclage[J]. 中国当代医药, 2022, 29(23): 10-14转29.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I23/10

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