血管细胞黏附分子1诊断胎膜早破合并绒毛膜羊膜炎的临床价值  

Clinical value of vascular cell adhension molecule-1 in diagnosis of premature rupture of membrane concomitant with chorioamnionitis

作　　者：卢丹 汪萍 王晓玲 顾学文 傅丹 

机构地区：[1]扬州大学临床医学院妇产科,225001 [2]扬州大学临床医学院中心实验室,225001 [3]扬州大学临床医学院病理科,225001

出　　处：《中国医药》2011年第2期212-213,共2页China Medicine

基　　金：江苏省社会发展科技计划资助项目（BS2001018）

摘　　要：目的 探讨母血、羊水、脐血中血管细胞黏附分子1（VCAM-1）对胎膜早破、绒毛膜羊膜炎和新生儿预后判断的临床意义.方法 采用双抗体夹心酶联免疫吸附法检测58例胎膜早破及38例正常孕妇（对照组）血清、羊水、脐血中VCAM-1水平的动态变化,同时进行胎膜的病理检查.结果 胎膜早破组血清、羊水、脐血中VCAM-1的含量[分别为（15.8±7.4）、（37.1±19.0）、（10.6±6.1）ng/L]均高于对照组,其含量随破膜时间的延长而增高,尤其破膜时间超过24 h增高更为明显.合并绒毛膜羊膜炎者血清、羊水、脐血中VCAM-1水平[分别为（19.8±6.9）、（55.1±21.3）、（13.7±5.7）ng/L]明显高于未合并绒毛膜羊膜炎者,差异具有统计学意义（P＜0.05,P＜0.01）,胎膜早破组产妇所生新生儿Apgar评分≤7分者,其母血、羊水、脐血中VCAM-1的含量[分别为（21.3±7.3）、（52.7±23.5）、（15.6±7.8）ng/L]显著高于Apgar≥8分的新生儿（P＜0.05,P＜0.01）.结论 VCAM-1细胞因子检测可用于胎膜早破并绒毛膜羊膜炎的早期诊断,对新生儿预后判断也具有一定的临床意义.Objective To evaluate cytokines levels （vascular cell adhension molecule-1,VCAM-1）in maternal serum,umbilical cord plasma and amniotic fluid in women with premature rupture of membranes （PROM）.Methods The levels of VCAM-1 in maternal serum,amniotic fluid,umbilical cord serum were detected by enzyme linked immunosorbent assay in 58 pregnant women with PROM and 38 women with normal pregnancies. Chorioamnionitis was histopathologically confirmed after delivery. Results The levels of VCAM-1 were significantly higher in patients in PROM group than those in control group（P 〈0.05,P 〈0.01）. The longer the duration from rupture of membrance to delivery was,the more serious chorioamnionitis was and the higher levels of VCAM-1 showed. The levels of VCAM-1were significantly higher in maternal serum,amniotic fluid,umbilical cord serum in patients with chorioamnionitis than those in non-chorioamnionitis （P 〈 0.05,P 〈 0.01）. The levels of VCAM-1 were significantly higher in neonates whose Apgar score≤7 than those in neonates whose Apgar score≥8. Conclusions Cytokines may implicate the pathophysiologic mechanisms of preterm and term labor combinding. Measurement of VCAM-1 concentrations in maternal serum,amniotic fluid,umbilical cord serum were useful biomarkers for identifying the chorioamnionitis and predicting PROM.

关 键 词：血管细胞黏附分子1 胎膜早破 绒毛膜羊膜炎 

分 类 号：R711[医药卫生—妇产科学]