孕妇产前组织型绒毛膜羊膜炎与新生儿缺氧缺血性脑病相关性分析  

Relationship between prenatal histological chorioamnionitis in pregnant women and neonatal hypoxic-ischemic encephalopathy

作　　者：杨金英 王倩菲 YANG Jinying;WANG Qianfei(Department of Neonatology,Xi’an People’s Hospital,Xi’an 710004,China)

机构地区：[1]西安市人民医院西安市第四医院新生儿科,陕西西安710004

出　　处：《陕西医学杂志》2023年第2期188-191,共4页Shaanxi Medical Journal

基　　金：西安市科技计划项目(2019115213YX007SF040)。

摘　　要：目的:分析孕妇产前组织型绒毛膜羊膜炎(HCA)与新生儿缺氧缺血性脑病(HIE)的相关性。方法:收集86例HCA孕产妇的临床资料(HCA组),并纳入同期入院的86例未发生HCA孕产妇作为对照组,比较两组孕产妇一般资料及HIE发生情况;根据是否发生HIE,将HCA组分为HCA-HIE组与HCA-非HIE组2个亚组,比较各组孕产妇胎膜组织Toll样受体4(TLR-4)、核因子-κB(NF-κB)表达水平差异,分析HCA孕产妇HIE临床分度与胎膜组织TLR-4、NF-κB表达水平的相关性。结果:HCA组与对照组孕产妇年龄、产次及早产史比较,差异无统计学意义(均P>0.05);HCA组破膜孕周低于对照组、新生儿出生体重及HIE发生率高于对照组(均P<0.05)。HCA-HIE组孕产妇胎膜组织TLR-4、NF-κB mRNA相对表达量高于HCA-非HIE组及对照组(均P<0.05),HCA-非HIE组高于对照组(P<0.05)。Spearman秩相关分析显示,HCA孕产妇HIE临床分度与胎膜组织TLR-4、NF-κB mRNA相对表达量呈显著正相关(r=0.379、0.394,均P<0.05)。结论:HCA可增加HIE发生风险,其作用机制可能与TLR-4/NF-κB信号通路有关。Objective:To analyze the relationship between prenatal histological chorioamnionitis(HCA)in pregnant women and neonatal hypoxic-ischemic encephalopathy(HIE).Methods:The clinical data of 86 pregnant and lying-in women with HCA were collected(HCA group),and 86 pregnant and lying-in women without HCA during the same period were included in control group.The baseline data and the occurrence of HIE were compared between the two groups.According to the presence or absence of HIE,the HCA group was divided into HCA-HIE group and HCA-non-HIE group.The differences in expression levels of Toll-like receptor 4(TLR-4)and nuclear factor-κB(NF-κB)in fetal membrane tissue of each group were compared.The correlation between clinical grading of HIE in pregnant and lying-in women with HCA and expression levels of TLR-4,NF-κB in fetal membrane tissue was analyzed.Results:TThere were no statistical differences in the age,parity and history of premature delivery between HCA group and control group(all P>0.05).The gestational age of rupture of membranes in HCA group was lower than that in control group,and the neonatal birth weight and the incidence rate of HIE were heavier or higher than those in control group(all P<0.05).The mRNA relative expression levels of TLR-4 and NF-κB in fetal membrane tissue of HCA-HIE group were significantly higher than those of HCA-non-HIE group and control group,and the above expression levels in HCA-non-HIE group were higher compared with those in control group(all P<0.05).Spearman rank correlation analysis showed that the clinical grading of HIE in pregnant and lying-in women with HCA was significantly positively correlated with the mRNA relative expression levels of TLR-4 and NF-κB in fetal membrane tissue(r=0.379,0.394,all P<0.05).Conclusion:THCA can increase the risk of HIE,and its role mechanism may be related to TLR-4/NF-κB signaling pathway.

关 键 词：组织型绒毛膜羊膜炎 胎膜早破 新生儿不良结局 新生儿缺氧缺血性脑病 组织Toll样受体4 核因子-ΚB 

分 类 号：R714.43[医药卫生—妇产科学]