Toll受体4的表达与胎膜早破患者绒毛膜羊膜炎的关系探讨  

Investigation of the Relationship Between the Expression of Toll Receptor 4 and Premature Rupture of Membranes with Chorioamnionitis

作　　者：李凯霞[1] 刘福民[2] 

机构地区：[1]徐州医学院研究生院,江苏徐州221004 [2]淮安市妇幼保健院,江苏淮安223300

出　　处：《中外医疗》2015年第19期1-2,7,共3页China & Foreign Medical Treatment

摘　　要：目的探讨分析Toll受体4(TLR4)的表达与胎膜早破患者绒毛膜羊膜炎的关系。方法随机选取2013年1月—2015年4月胎膜早破病例30例(研究组)与正常晚期妊娠女性30例(对照组),分别测定胎盘组织TLR4定位、表达特点以及白介素-6(IL-6)、白介素-8(IL-8)水平,予以产后胎膜病理检查。结果 2组TLR4胎盘表达情况以及胎盘TLR4 m RNA水平差异无统计学意义(P>0.05);研究组血清IL-8水平明显高于对照组,差异有统计学意义(P<0.05)。最终检查发现组织绒毛膜羊膜炎23例,TLR4表达水平差异无统计学意义(P>0.05),TLR4 m RNA水平高于无组织绒毛膜羊膜炎者,组织绒毛膜羊膜炎者IL-6、IL-8水平高于无组织绒毛膜羊膜炎者,差异有统计学意义(P<0.05)。该组胎膜组织病理检查确认为亚临床型绒毛膜羊膜炎,三期急性炎性改变,Ⅰ期、Ⅱ、Ⅲ期改变逐渐明显。结论 TLR4上升以及IL-8上升均与绒毛膜羊膜炎有关联,IL-8变化关系到胎膜完整性,对TLR4的监测是防控胎膜早破、绒毛膜羊膜炎的关键。Objective To investigate the relationship between the expression of Toll receptor 4 （TLR4） and premature rupture of membranes with chorioamnionitis. Methods 30 cases with premature rupture of membranes（study group） and 30 normal pregnant women in late pregnancy（control group） were selected. All the subjects underwent the measurement of the positioning and expression characteristics of placenta TLR4, and the level of IL-6 and IL-8, and postpartum fetal membrane pathology examination. Results There was no statistically significant difference in the expression of placenta TLR4 and the level of TLR4 mRNA between the two groups（P〉0.05）. The level of serum IL-8 was much higher in the study group than in the control group （P〈0.05）. The final check found that 23 cases with chorioamnionitis, no statistically significant difference in the expression level of TLR4 was found between the groups（P〉0.05）. Chorioamnionitis patients had higher TLR4 mRNA level than patients without chorioamnionitis. Chorioamnionitis patients had higher IL-6 and IL-8 level than patients without chorioamnionitis（P〈0.05）. Postpartum fetal membrane pathology examination identified subclinical chorioamnionitis with stage Ⅲacute inflammatory changes and stageⅠ,Ⅱ,Ⅲgradually significant changes. Conclusion The rise of TLR4 and IL-8 levels is associated with chorioamnionitis;changes of IL-8 are associated with fetal membrane integrity;the monitoring of TLR4 is the key to preventing and controlling the incidence of premature rupture of membranes and chorioamnionitis.

关 键 词：Toll受体4 表达 胎膜早破 绒毛膜羊膜炎 

分 类 号：R714.56[医药卫生—妇产科学]