The Value of the Leukocyte Esterase Test in Diagnosing Intra-Amniotic Infection
The Value of the Leukocyte Esterase Test in Diagnosing Intra-Amniotic Infection
复制标题
白细胞酯酶试验诊断羊膜内感染的价值
DOI：
10.1055/s-2007-999657
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发表时间：
1988
影响因子：
2
通讯作者：
J. Hobbins
中科院分区：
文献类型：
--
作者：
Roberto Romero;M. Emamian;M. Wan;Shaul Yarkoni;W. Mccormack;M. Mazor;J. Hobbins
本文探讨白细胞酯酶活性（莱亚）试验在检测羊膜内感染中的诊断价值。通过羊水穿刺术获取了171例连续的胎膜早破（n = 149）和早产（n = 22）患者的羊水。进行革兰氏染色、细菌和支原体培养以及莱亚试验。莱亚预测羊水培养阳性的敏感性为19%，特异性为86.7%，阳性预测值（PPV）为42.3%，阴性预测值（NPV）为67.6%（阳性培养率= 33.9%）。革兰氏染色法的敏感性为36.2%，特异性为94.7%，阳性预测值为77.8%，阴性预测值为74.3%。当这两种测试相结合时，观察到灵敏度显著增加至50%。这与特异性下降至81.4%相关。羊水中的白色血细胞数与莱亚试验结果之间存在相关性。阳性莱亚检测与产后子宫内膜炎的可能性增加相关，但与临床绒毛膜炎或新生儿感染性发病率无关。
This communication examines the diagnostic value of the leukocyte esterase activity (LEA) test in the detection of intra-amniotic infection. Amniotic fluid from 171 consecutive patients with premature rupture of membranes (n = 149) and preterm labor (n = 22) was obtained through amniocentesis. Gram stain, bacterial and mycoplasma cultures, and LEA tests were performed. The LEA had a sensitivity of 19%, a specificity of 86.7%, a positive predictive value (PPV) of 42.3% and a negative predictive value (NPV) of 67.6% in the prediction of a positive amniotic fluid culture (prevalence of positive cultures = 33.9%). The Gram stain had a sensitivity of 36.2%, specificity of 94.7%, PPV of 77.8%, and NPV of 74.3%. When both tests were combined, a significant increase in sensitivity to 50% was observed. This was associated with a drop in specificity to 81.4%. There was a correlation between the number of white blood cells in the amniotic fluid and the result of the LEA test. A positive LEA assay was associated with an increased likelihood of postpartum endometritis, but not with clinical chorioamnionitis or neonatal infectious morbidity.
DOI：
10.1056/nejm198203253061207
发表时间：
1982
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gravett,MG;Eschenbach,DA;Speigel-Brown,CA;Holmes,KK
通讯作者：
Holmes,KK