胎膜早破患者血清SAA、NLRP3及Fasl表达水平对绒毛膜羊膜炎的预测价值  

Predictive value of serum SAA,NLRP3 and Fasl for chorioamnionitis in patients with premature rupture of membranes

作　　者：李虹[1] 沈鑫[1] 折开娥[1] 吴桂清[1] 王敏[1] 孙港港 王雯智[1] LI Hong;SHEN Xin;ZHE Kai’e;WU Guiqing;WANG Min;SUN Ganggang;WANG Wenzhi(Department of Obstetrics,ShanxiPeople’s Hospital,Xi’an Shanxi 710068,China)

机构地区：[1]陕西省人民医院产科,西安710068

出　　处：《中国妇产科临床杂志》2023年第1期62-65,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：陕西省重点研发计划项目(2020SF-050)。

摘　　要：目的 探讨血清淀粉蛋白样A(SAA)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)及可溶性FasrymndritFas配体(sFasl)表达水平在胎膜早破(PROM)的孕产妇中对绒毛膜羊膜炎的预测价值。方法 前瞻性选取陕西省人民医院2019年2月至2021年8月80例PROM孕产妇,分娩后将产妇胎盘、胎膜组织进行病理检查,包括绒毛膜羊膜炎42例,非绒毛膜羊膜炎38例。将绒毛膜羊膜炎组按分期分为Ⅰ期(n=14)、Ⅱ期(n=18)、Ⅲ期(n=10)三个亚组,观察血清SAA、NLRP3、sFasl表达水平,评估其在疾病诊断和严重程度评估中的应用价值。结果 绒毛膜羊膜炎组血清SAA、NLRP3、sFasl表达水平高于非绒毛膜羊膜炎组(P <0.05);血清SAA、NLRP3、sFasl表达水平联合检测评估PROM绒毛膜羊膜炎ROC曲线下面积为0.878,高于各项指标单独检测0.791、0.776、0.734(P <0.05);绒毛膜羊膜炎孕产妇血清SAA、NLRP3、sFasl水平比较,Ⅲ期>Ⅱ期>Ⅰ期(P <0.05);Spearman相关性分析显示,绒毛膜羊膜炎程度与血清SAA、NLRP3、sFasl表达水平呈正相关(r=0.371、0.306、0.297,P <0.005)。结论 合并绒毛膜羊膜炎PROM孕产妇血清SAA、NLRP3、sFasl呈现高表达水平,在一定程度上反映PROM孕产妇绒毛膜羊膜炎的发生,且其表达与绒毛膜羊膜炎程度呈正相关。Objective To explore the predictive value of serum amyloid A(SAA),nucleotide-binding oligomerization domain-like receptor 3(NLRP3) and soluble FasrymndritFas ligand(sFasl) for chorioamnionitis in pregnant women with premature rupture of membranes(PROM).Methods A total of 80 pregnant women with PROM in the hospital were proactively enrolled between February 2019 and August 2021.According to pathological results of placenta and fetal membrane tissues after delivery,there were 42 cases with chorioamnionitis in chorioamnionitis group and 38 cases without chorioamnionitis in non-chorioamnionitis group.According to different staging,patients in chorioamnionitis group were divided into stageⅠgroup(n = 14),stage Ⅱ group(n = 18) and stage Ⅲ group(n = 10).The expression levels of serum SAA,NLRP3 and sFasl were observed.Their application value in disease diagnosis and severity evaluation was assessed.Results The expression levels of serum SAA,NLRP3 and sFasl in chorioamnionitis group were higher than those in non-chorioamnionitis group(P < 0.05).The area under the ROC curve(AUC) of SAA combined with NLRP3 and sFasl for evaluating chorioamnionitis was 0.878,greater than that of single index(0.791,0.776,0.734)(P < 0.05).The levels of serum SAA,NLRP3 and sFasl were the highest in stage Ⅲ group,followed by stage Ⅱ group and stage I group(P < 0.05).Spearman correlation analysis showed that the severity of chorioamnionitis was positively correlated with expression levels of serum SAA,NLRP3 and sFasl(r = 0.371,0.306,0.297,P < 0.005).Conclusions The expression levels of serum SAA,NLRP3 and sFasl are higher in pregnant women with PROM and chorioamnionitis,which can refl ect the occurrence of chorioamnionitis to a certain extent.Their expression levels are positively correlated with the severity of chorioamnionitis.

关 键 词：胎膜早破 绒毛膜羊膜炎 淀粉蛋白样A 核苷酸结合寡聚化结构域样受体蛋3 FasrymndritFas配体 

分 类 号：R714.433[医药卫生—妇产科学]