孕中期宫颈阴道分泌物中IL-6、TNF-α和CRH的水平与早产的关系  

Relationship between mid-gestational changes in cervicovaginal fluid inflammatory cytokine levels in pregnant women and preterm birth

作　　者：丁晓颖[1] 蔡燕[1] 杨慧琳[1] 邢秋霞[1] 陆玲玲 程妤奋 沈丽华[1] 黄鹰[1] DING Xiao-ying;CAI Yan;YANG Hui-lin;XING Qiu-xia;LU Ling-ling;CHENG Yu-fen;SHEN Li-hua;HUANG Ying(Department of Gynecology and Obstetrics,Pudong District Healtheare for Women and Children,Shanghai 201206,China)

机构地区：[1]上海市浦东新区妇幼保健院妇产科,上海201206

出　　处：《中国妇幼健康研究》2018年第11期1414-1418,共5页Chinese Journal of Woman and Child Health Research

基　　金：上海市卫计委课题基金资助项目(编号:201440003)

摘　　要：目的分析孕中期妇女宫颈阴道分泌物中炎性因子和促肾上腺皮质激素释放激素(CRH)的水平变化与早产的相关性。方法选择2015年1月至2017年12月在上海浦东新区妇幼保健院正规产检的孕产妇,随机抽取100例早产妇女及100例足月产妇女为研究对象,采用酶联免疫吸附试验(ELISA)法检测其孕中期宫颈阴道分泌物中白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α和CRH的浓度,并分析CRH表达改变与炎性因子水平变化有无相关性。结果 (1)早产组孕24～28周宫颈阴道分泌物中IL-6、TNF-α和CRH水平均高于足月产组,差异有显著性(t值分别为45.230、8.062、3.018,均P<0.05)。(2)早产组孕24～28周宫颈阴道分泌物中CRH表达上调与IL-6、TNF-α水平升高均呈显著正相关(R^2值分别为0.590和0.223,均P<0.05),而足月产组孕24～28周宫颈阴道分泌物中CRH表达上调与IL-6水平呈正相关(R^2=0.139,P<0.05),与TNF-α水平无相关性(R^2=0.000,P>0.05)。结论孕中期妇女宫颈阴道分泌物中IL-6、TNF-α和CRH水平的升高与早产密切相关,孕中期联合以上三项检测可为早产的预测提供更为有效准确的方法。Objective To determine the correlation between changes in inflammatory cytokine and corticotrophin-releasing hormone（CRH）concentrations in mid-trimester cervicovaginal secretions and preterm birth.Methods One hundred preterm pregnant women and 100 full-term pregnant women were recruited in the study.The concentrations of interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）and CRH in cervicovaginal secretions were examined by enzyme-linked immunosorbent assay（ELISA）,and the correlation between the changes of CRH expression and the levels of inflammatory factors was analyzed.Results During 24-28 gestational weeks,the levels of IL-6,TNF-α and CRH in cervicovaginal secretions of mid-trimester in preterm group were significantly higher than those in full-term group（t value was 3.701,8.062 and 3.018,respectively,all P〈0.05）.Higher expression of CRH was positively correlated with the increased levels of IL-6 and TNF-α（R^2 value was 0.59 and 0.223,respectively,both P〈0.05）in preterm group,while in full-term group it was positively correlated with IL-6 level（R^2=0.139,P〈0.05）but not correlated with TNF-α（R^2=0.000,P〈0.05）.Conclusion The increase of IL-6,TNF-α and CRH levels in midtrimester is closely correlated with preterm birth.Joint detection of IL-6,TNF-α and CRH levels in cervicovaginal secretions in mid-trimester provides a more effective and accurate method for predicting preterm labor.

关 键 词：宫颈阴道分泌物 白细胞介素-6 肿瘤坏死因子-Α 促肾上腺激素释放激素 早产 

分 类 号：R714.2[医药卫生—妇产科学]