ENO2/NLRP3炎症小体通路表达对胎膜早破孕妇并发羊膜腔感染的预测价值  

Values of ENO2/NLRP3 inflammasome pathways in prediction of intraamniotic infection of pregnant women with premature rupture of membranes

作　　者：西慧芳[1] 范宁[2] 梁红 王静 胥潇 XI Hui-fang;FAN Ning;LIANG Hong;WANG Jing;XU Xiao(The First Affiliated Hospital of Shandong First Medical University(Qianfoshan Hospital of Shandong Province),Jinan,Shandong 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)产房,山东济南250014 [2]济南市妇幼保健院手术室,山东济南250001 [3]济南市妇幼保健院产房,山东济南250001

出　　处：《中华医院感染学杂志》2022年第19期3012-3016,共5页Chinese Journal of Nosocomiology

基　　金：山东省科研基金资助项目(Q202021141)。

摘　　要：目的分析γ-烯醇化酶(ENO2)与NLRP3炎症小体通路表达对胎膜早破(PROM)孕妇并发羊膜腔感染综合征(IAIS)的预测价值。方法选取2018年1月-2019年12月于山东第一医科大学第一附属医院分娩的300例PROM孕妇,入组即刻留取外周静脉血及羊水样本,分离上清液后分别检测其中炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8]水平;分娩时留取胎盘绒毛膜羊膜组织,测定其中ENO2、NLRP3炎症小体[NLRP3、凋零相关斑点样蛋白(ASC)、半胱天冬氨酸蛋白酶-1(Caspase-1)]mRNA表达水平,根据分娩后胎盘胎膜病理检测结果分为IAIS组(n=180)、非IAIS组(n=120)。分别比较两组孕妇血清、羊水样本炎症因子水平,及绒毛膜羊膜组织ENO2、NLRP3炎症小体mRNA表达量,采用Pearson相关性分析其中关系,并采用受试者工作特征(ROC)曲线描述ENO2、NLRP3炎症小体mRNA表达量单独及联合检测对PROM并发IAIS的预测效能。结果IAIS组孕妇血清及羊水样本TNF-α、IL-6、IL-8水平及胎盘绒毛膜羊膜组织ENO2、NLRP3、ASC、Caspase-1 mRNA表达水平均高于非IAIS组(均P<0.05);Pearson相关性分析显示,PROM孕妇胎盘绒毛膜羊膜组织ENO2、NLRP3、ASC、Caspase-1 mRNA表达水平与血清及羊水样本TNF-α、IL-6、IL-8水平均呈正相关(均P<0.05);ROC曲线显示,绒毛膜羊膜组织ENO2、NLRP3、ASC、Caspase-1 mRNA表达量单独及联合预测PROM并发IAIS的最佳截断值分别为94.940、100.660、110.290、100.150、197.692,对应的ROC曲线下的面积分别为0.937、0.915、0.889、0.870、0.998。结论PROM孕妇胎盘绒毛膜羊膜组织ENO2、NLRP3炎症小体异常高表达与IAIS的发生有关,其可能通过促进炎症因子表达而参与该过程。OBJECTIVE To analyze the values of expressions ofγ-enolase(Enolase-2,ENO2)and NOD-like receptor protein 3(NLRP3)inflammasome pathways in prediction of intraamniotic infectious syndrome(IAIS)in pregnant women with premature rupture of membranes(PROM).METHODS Totally 300 pregnant women with PROM who gave birth in the First Affiliated Hospital of Shandong First Medical University were selected between Jan.2018 and Dec.2019.Peripheral venous blood and amniotic fluid samples were collected immediately after enrollment,and the supernatant was separated and the levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]were detected.Placental chorionic amniotic tissues were collected during delivery.The mRNA expression levels of ENO2 and NLRP3 inflammasomes[NLRP3,apoptosis-associated speck-like protein containing a CARD(ASC),cysteine-containing aspartate-specific proteases-1(Caspase-1)]were measured.According to the pathological detection results of the placenta and fetal membranes after delivery,the pregnant women were divided into IAIS group(n=180)and non-IAIS group(n=120).The levels of inflammatory factors in serum and amniotic fluid samples and mRNA expression levels of ENO2 and NLRP3 inflammasomes in chorionic amniotic tissues were compared between the two groups of pregnant women.Pearson correlation analysis was used to analyze the relationship,and receiver operating characteristic(ROC)curves were used to describe the predictive efficiency of mRNA expressions of ENO2 and NLRP3 inflammasomes and combined detection on PROM with IAIS.RESULTS The levels of TNF-α,IL-6 and IL-8 in serum and amniotic fluid samples and the mRNA expression levels of ENO2,NLRP3,ASC and Caspase-1 in placental chorionic amniotic tissues of pregnant women in IAIS group were higher than those in non-IAIS group(all P<0.05).Pearson correlation analysis showed that the mRNA expression levels of ENO2,NLRP3,ASC and Caspase-1 in placental chorionic amniotic tissues of pregnant women with PROM were positi

关 键 词：γ-烯醇化酶 NLRP3炎症小体 炎症因子 胎膜早破 羊膜腔感染 预测价值 

分 类 号：R714.433[医药卫生—妇产科学]