胎膜早破孕妇外周血和胎膜组织中氧化型α1-抗胰蛋白酶、中性粒细胞弹性蛋白酶表达及临床意义  

The expression and clinical significance of oxidizedα1-antitrypsin and neutrophil elastase in peripheral blood and fetal membrane tissues of pregnant women with premature rupture of membranes

作　　者：汪洪友[1] 周建波[1] 王春霞[1] 王永芳[1] Wang Hongyou;Zhou Jianbo;Wang Chunxia;Wang Yongfang(Department of Gynaecology and Obstetrics,Binhai County People′s Hospital,Jiangsu Yancheng 224500,China)

机构地区：[1]江苏省滨海县人民医院妇产科,224500

出　　处：《中国医师进修杂志》2021年第2期158-162,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨胎膜早破(PROM)孕妇外周血和胎膜组织中氧化型α1-抗胰蛋白酶(ox-AAT)、中性粒细胞弹性蛋白酶(NE)表达的临床意义。方法回顾性分析2019年4月至2020年4月江苏省滨海县人民医院收治的95例PROM产妇的临床资料,依据是否合并组织学绒毛膜羊膜炎(HCA)分为PROM合并HCA组(31例)和PROM未合并HCA组(64例),另选择同期50例正常妊娠产妇作为健康对照组。比较各组外周血和胎膜组织中ox-AAT、NE表达水平。结果PROM合并HCA组外周血ox-AAT和NE水平高于PROM未合并HCA组和健康对照组[(2.34±0.02)ng/L比(1.50±0.12)和(0.32±0.04)ng/L和(0.48±0.08)ng/L比(0.13±0.06)和(0.11±0.05)ng/L],PROM未合并HCA组外周血ox-AAT水平高于健康对照组[(1.50±0.12)ng/L比(0.32±0.04)ng/L],差异均有统计学意义(P<0.05)。PROM合并HCA组胎膜组织中ox-AAT和NE水平高于PROM未合并HCA组和健康对照组[(0.031±0.005)ng/L比(0.015±0.002)和(0.009±0.003)ng/L、(0.020±0.002)ng/L比(0.003±0.001)和(0.002±0.001)ng/L],PROM未合并HCA组胎膜组织中ox-AAT水平高于健康对照组[(0.015±0.002)ng/L比(0.009±0.003)ng/L],差异均有统计学意义(P<0.05)。Pearson相关分析显示外周血中ox-AAT水平与NE水平呈正相关(r=0.879,P<0.05),胎膜组织中ox-AAT水平与NE水平呈正相关(r=0.875,P<0.05)。PROM合并HCA组和PROM未合并HCA组胎盘早剥发生率较健康对照组高[32.26%(10/31)、20.31%(13/64)比4.00%(2/50)],PROM合并HCA组新生儿肺炎发生率较PROM未合并HCA组和健康对照组高[25.81%(8/31)比9.38%(6/64)和2.00%(1/50)],差异均有统计学意义(P<0.05)。结论ox-AAT在PROM产妇外周血和胎膜组织中过表达,NE在合并HCA的PROM外周血和胎膜组织中过表达,ox-AAT和NE表达增强与围生期不良结局密切相关。Objective To investigate the clinical significance of the expression of oxidizedα1-antitrypsin(ox-AAT)and neutrophil elastase(NE)in the peripheral blood and fetal membrane tissues of pregnant women with premature rupture of membranes(PROM).Methods The clinical data of 95 cases of PROM pregnant women admitted to Binhai County People′s Hospital from April 2019 to April 2020 were analyzed.According to combination of histological chorioamnionitis(HCA),they were divided into PROM combined with HCA group(31 patients)and PROM without HCA group(64 patients).Besides,50 normal pregnant women were collected during the same period as a healthy control group.The expression levels of ox-AAT and NE in the peripheral blood and fetal membrane tissues of the three groups were compared and analyzed.Results The levels of peripheral blood ox-AAT and NE in the PROM combined with HCA group were higher than those in PROM without HCA group and healthy control group:(2.34±0.02)ng/L vs.(1.50±0.12),(0.32±0.04)ng/L;(0.48±0.08)ng/L vs.(0.13±0.06),(0.11±0.05)ng/L;the level of peripheral blood ox-AAT in PROM without HCA group was higher than that in healthy control group:(1.50±0.12)ng/L vs.(0.32±0.04)ng/L,and the differences were statistically significant(P<0.05).The levels of fetal membrane tissues ox-AAT and NE in the PROM combined with HCA group were higher than those in PROM without HCA group and healthy control group:(0.031±0.005)ng/L vs.(0.015±0.002),(0.009±0.003)ng/L;(0.020±0.002)ng/L vs.(0.003±0.001),(0.002±0.001)ng/L;the level of fetal membrane tissues ox-AAT in PROM without HCA group was higher than that in the healthy control group:(0.015±0.002)ng/L vs.(0.009±0.003)ng/L,and the differences were statistically significant(P<0.05).There was a positive correlation between ox-AAT and NE in peripheral blood and fetal membrane tissues(r=0.879,0.875,P<0.05).The incidence of placental abruption in the PROM combined with HCA group and PROM without HCA group was higher than that in the healthy control group:32.26%(10/31),20.3

关 键 词：胎膜早破 妊娠结局 组织学绒毛膜羊膜炎 氧化型α1-抗胰蛋白酶 中性粒细胞弹性蛋白酶 

分 类 号：R714.433[医药卫生—妇产科学]