胎膜早破产妇血清SFRP5,TIMP-1和HMGB1水平与并发组织学绒毛膜羊膜炎的相关性研究  

Correlation of Serum SFRP5,TIMP-1 and HMGB1 Levels with Histological Chorioamnitis in Pregnant Women with Premature Rupture of Membranes

作　　者：吴慧 韩文龙 柏蕾 孙红丽 WU Hui;HAN Wen-long;BO Lei;SUN Hong-li(Department of Obstetrics,Hebei Maternity Hospital,Shijiazhuang 050090,China;Department of Medical Laboratory,Hebei Maternity Hospital,Shijiazhuang 050090,China;Department of Obstetrics and Gynecology,Affiliated Hospital of Jining Medical College,Shandong Jining 272001,China)

机构地区：[1]河北生殖妇产医院产科,石家庄050090 [2]河北生殖妇产医院医学检验科,石家庄050090 [3]济宁医学院附属医院妇产科,山东济宁272001

出　　处：《现代检验医学杂志》2022年第5期112-117,158,共7页Journal of Modern Laboratory Medicine

基　　金：河北省医学科学研究课题(20191408),资助单位:河北省卫生健康委员会。

摘　　要：目的 探讨胎膜早破(premature rupture of membranes,PROM)产妇血清分泌型卷曲相关蛋白5(secreted frizzled-related protein-5,SFRP5)、基质金属蛋白酶组织抑制剂1(tissue inhibitor of metalloproteinase 1,TIMP-1)和高迁移率族蛋白B1(high mobility group protein B1,HMGB1)水平与组织学绒毛膜羊膜炎(histologic chorioamnionitis,HCA)的关系。方法 选择2019年6月~2021年8月河北生殖妇产医院产科收治的72例足月PROM并发HCA产妇(HCA组),120例足月PROM未发生HCA产妇(非HCA组)和51例足月妊娠未发生PROM产妇(对照组)。检测血清SFRP5,TIMP-1和HMGB1水平,分析其与PROM产妇发生HCA的关系。绘制受试者工作特征(ROC)曲线,分析SFRP5,TIMP-1和HMGB1诊断PROM产妇发生HCA的价值。结果 HCA组血清SFRP5(7.53±1.42 mg/L)和TIMP-1(102.35±16.67 ng/ml)水平低于非HCA组(10.23±2.11 mg/L,185.23±29.42 ng/ml)和对照组(15.23±3.06mg/L,242.13±32.65 ng/ml),差异均有统计学意义(F=187.726,423.352,均P<0.05);血清HMGB1水平(10.25±3.26ng/ml)高于非HCA组(6.02±1.41 ng/ml)和对照组(3.06±0.81 ng/ml),差异有统计学意义(F=191.968,P<0.05)。多因素Logistic回归分析示PROM破膜时间≥48h[OR=2.208,95%CI=1.466~3.326],阴道检查次数≥3次[OR=1.540,95%CI=1.206~1.968],SFRP5<7.53mg/L[OR=1.657,95%CI=1.220~2.250],TIMP-1<102.35ng/ml[OR=1.826,95%CI=1.275~2.613]和HMGB1≥10.25ng/ml[OR=1.809,95%CI=1.237~2.647]是PROM产妇发生HCA的危险因素(均P<0.05)。SFRP5,TIMP-1和HMGB1诊断足月PROM产妇发生HCA的曲线下面积分别为0.707,0.731和0.747,联合诊断曲线下面积为0.933,高于单独指标(Z=5.822,5.611,5.274,均P=0.000)。结论PROM产妇血清SFRP5和TIMP-1水平降低,HMGB1水平升高,且与HCA发病密切相关。SFRP5,TIMP-1和HMGB1可作为HCA诊断的生物标志物。Objective To investigate the relationship between serum secreted frizzled-related protein-5(SFRP5),tissue inhibitor of metalloproteinase 1(TIMP-1),high mobility group protein B1(HMGB1)and histologic chorioamnionitis(HCA)in pregnant women with premature rupture of membranes(PROM).Methods From June 2019 to August 2021,72 cases of full-term PROM with HCA(HCA group),120 cases of full-term PROM without HCA(non-HCA group)and 51 cases of full-term pregnancy without PROM(control group)from Hebei Maternity Hospital were selected.Serum level of SFRP5,TIMP-1 and HMGB1 were detected to analyze the relationship between SFRP5,TIMP-1 and HMGB1 and HCA in PROM parturient women.Receiver operating characteristic curve(ROC)was drawn to analyze the value of SFRP5,TIMP-1 and HMGB1 in diagnosing HCA in PROM parturient.Results The levels of serum SFRP5(7.53±1.42 mg/L)and TIMP-1(102.35±16.67 ng/ml)in HCA group were lower than those in non-HCA group(10.23±2.11 mg/L,185.23±29.42 ng/ml)and control group(15.23±3.06mg/L,242.13±32.65 ng/ml),the differences were statistically significant(F =187.726,423.352,all P<0.05),and the levels of serum HMGB1(10.25±3.26 ng/ml)were higher than those in non-HCA group(6.02±1.41 ng/ml)and control group(3.06±0.81 ng/ml),the difference was statistically significant(F=191.968,P<0.05).Multivariate Logistic regression analysis showed that PROM rupture time ≥ 48h [OR=2.208,95%CI=1.466~3.326],vaginal examination times ≥ 3[OR=1.540,95%CI=1.206~1.968],SFRP5<7.53mg/L[OR=1.657,95%CI=1.220~2.250],TIMP-1<102.35ng/ml[OR=1.826,95%CI=1.275~2.613] and HMGB1 ≥ 10.25ng/ml[OR=1.809,95%CI=1.237~2.647] were risk factors for HCA in PROM parturient women(all P<0.05).The area under the curve of SFRP5,TIMP-1 and HMGB1 were 0.707,0.731and 0.747,respectively,and the area under the curve of SFRP5,TIMP-1 and HMGB1 were 0.933,higher than the single index(Z=5.822,5.611 and 5.274,all P<0.05).Conclusion The serum levels of SFRP5 and TIMP-1 in PROM maternal decreased,while the serum level of HMGB1 increased,which were closely re

关 键 词：胎膜早破 分泌型卷曲相关蛋白5 基质金属蛋白酶组织抑制剂1 高迁移率族蛋白B1 组织学绒毛膜羊膜炎 

分 类 号：R714.433[医药卫生—妇产科学] R446.11[医药卫生—临床医学]