Expression of MMP-9,IL-6 and CRP in Premature Rupture of Fetal Membrane and its Influence on Prognosis

Hu Yonghe; He Yanhong; Lan Liubing

doi:10.3969/j.issn.1004-5775.2024.22.001

Abstract：Objective:To investigate the expression of matrix metalloproteinase-9(MMP-9)interleukin-6(IL-6)and C-reactive protein(CRP)in premature rupture of fetal membrane and its influence on prognosis.Methods:39 full-term pregnant women with premature rupture of membranes who received diagnosis and treatment in the obstetrics and gynecology department of the hospital from December 2022 to December 2023 were collected as the research subjects.They were divided into non-infected group(n=23)and infected group(n=16)according to the infection status of pregnant women with premature rupture of membranes.In addition,39 pregnant women with full-term delivery admitted to the obstetrics department of the hospital during the same period were selected as the control group.The concentrations of serum MMP-9,IL-6 and CRP were detected.The serum levels of MMP-9,IL-6 and CRP were compared between control group and observation group.The levels of MMP-9,IL-6 and CRP were compared between the non-infected group and the infected group.The diagnostic efficacy(sensitivity,specificity and predictive value of positive and negative)of single and combined MMP-9,IL-6 and CRP in the diagnosis of intrauterine infection in pregnant women with premature rupture of membranes was analyzed,and receiver operating characteristic curve(ROC)curve was drawn.Results:The observation group had significantly higher serum levels of MMP-9,IL-6 and CRP than the control group(t=2.273,2.750,24.916;P＜0.05).The serum levels of MMP-9,IL-6 and CRP in the infection group were higher than those in the control group(t=3.176,5.667,15.970;P＜0.05).The sensitivity,specificity,positive predictive value and negative predictive value of combined detection were higher than those of single detection of MMP-9,IL-6 and CRP(P＜0.05).ROC curve analysis showed that when serum was MMP-9≥70.82 ng/L,the area under the curve(AUC)was 0.731,the diagnostic sensitivity was 62.50%,and the specificity was 78.26% .When serum IL-6≥5.68 pg/ml,the AUC was 0.752,the diagnostic sensitivity was 56.25%,and the specificity was 73.91% .When serum CRP≥6.85 mg/L,the AUC was 0.715,the diagnostic sensitivity was 55.56%,and the specificity was 76.19% .The AUC of combined detection was 0.873,the diagnostic sensitivity was 93.75%,and the specificity was 95.65% .Conclusion:The serum MMP-9,IL-6 and CRP of pregnant women with term premature rupture of membranes were higher than those of pregnant women with term delivery and pregnant women without term premature rupture of membranes,and the combined diagnosis of serum MMP-9,IL-6 and CRP was more effective,which could be used as an important index to jointly predict the infection of term premature rupture of membranes.It has positive guiding significance for improving prognosis of pregnant women with premature rupture of membranes.