宫颈阴道液IL-6、IL-10及IL-19对未足月胎膜早破继发胎儿炎症反应综合征的预测价值  

Predictive value of IL-6,IL-10 and IL-19 in cervical-vaginal fluid for fetal inflammatory response syndrome secondary to preterm premature rupture of membranes

作　　者：张龙华[1] 赵军[2] 许耀辉[2] 周杰[1] ZHANG Longhua;ZHAO Jun;XU Yaohui;ZHOU Jie(Department of Obstetrics,Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University,Wuxi 214000,Jiangsu,China;Clinical of Laboratory,Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University,Wuxi 214000,Jiangsu,China)

机构地区：[1]南京医科大学附属无锡市妇幼保健院产科,江苏无锡214000 [2]南京医科大学附属无锡市妇幼保健院检验科,江苏无锡214000

出　　处：《西部医学》2023年第5期724-728,734,共6页Medical Journal of West China

基　　金：江苏省卫生健康委医学科研面上项目(M20200066)。

摘　　要：目的探讨宫颈阴道液白细胞介素-6(IL-6)、白细胞介素-10(IL-10)及白细胞介素-19(IL-19)对未足月胎膜早破(pPROM)继发胎儿炎症反应综合征(FIRS)的预测价值。方法选择2017年12月—2020年12月本院收治的96例pPROM患者,根据是否发生FIRS将患者分为FIRS组(31例)和非FIRS组(65例)。采用酶联免疫吸附试验检测宫颈阴道液以及脐血中IL-6、IL-10、IL-19水平。分析宫颈阴道液和脐血中IL-6、IL-10、IL-19的相关性,pPROM继发FIRS的因素以及宫颈阴道液中IL-6、IL-10、IL-19预测pPROM继发FIRS的价值。结果FIRS组宫颈阴道液、脐血中IL-6、IL-19水平高于非FIRS组(P<0.05),IL-10水平低于非FIRS组(P<0.05)。宫颈阴道液中IL-6、IL-10、IL-19与脐血中IL-6、IL-10、IL-19呈高度正相关(r=0.623、0.602、0.618,P<0.05)。羊膜腔感染、宫颈阴道液IL-6、IL-19水平升高是pPROM继发FIRS的危险因素(P<0.05),IL-10水平升高是保护因素(P<0.05)。宫颈阴道液中IL-6、IL-10、IL-19预测pPROM继发FIRS的曲线下面积为0.732、0.780、0.723,联合指标预测pPROM继发FIRS的曲线下面积为0.884,高于单独指标预测(Z=2.696、2.238、2.817,P<0.05)。结论宫颈阴道液中IL-10水平降低,IL-6、IL-19水平升高与pPROM继发FIRS密切相关,宫颈阴道液中IL-6,IL-10,IL-19与脐血IL-6,IL-10,IL-19具有较好相关性,可作为FIRS的辅助指标。Objective To investigate the predictive value of interleukin-6(IL-6),interleukin-10(IL-10)and interleukin-19(IL-19)in cervical-vaginal fluid for fetal inflammatory response syndrome(FIRS)secondary to preterm premature rupture of membranes(pPROM).Methods 96 patients with pPROM admitted to our hospital from December 2017 to December 2020 were divided into FIRS group(31 cases)and non-FIRS group(65 cases)according to the occurrence of FIRS.The levels of IL-6,IL-10 and IL-19 in cervical vaginal fluid and umbilical cord blood were detected by enzyme chain immunosorbent assay.The correlation of IL-6,IL-10 and IL-19 in cervical vaginal fluid and umbilical cord blood,the factors of FIRS secondary to pPROM,and the value of IL-6,IL-10 and IL-19 in cervical vaginal fluid in predicting FIRS secondary to pPROM were analyzed.Results The levels of IL-6 and IL-19 in cervix vaginal fluid and cord blood in FIRS group were higher than those in non-FIRS group(P<0.05),and the levels of IL-10 were lower than those in non-FIRS group(P<0.05).The levels of IL-6,IL-10 and IL-19 in cervical vaginal fluid were highly positively correlated with those in cord blood(r=0.623,0.602,0.618,P<0.05).Amniotic cavity infection and increased levels of IL-6 and IL-19 in cervical-vaginal fluid were risk factors for FIRS secondary to pPROM(P<0.05),while increased levels of IL-10 were protective factors(P<0.05).The area of IL-6,IL-10 and IL-19 in cervical vaginal fluid to predict FIRS secondary to pPROM was 0.732,0.780 and 0.723 respectively,and combined index was 0.884,which was higher than that of single index(Z=2.696,2.238 and 2.817,P<0.05).Conclusion The level of IL-10 decreased in cervical vaginal fluid,and the level of IL-6 and IL-19 increased is closely related to FIRS secondary to pPROM.Il-6,IL-10,IL-19 in cervical vaginal fluid were correlated with THAT in umbilical cord blood,can be used as an auxiliary indicator of FIRS.

关 键 词：胎膜早破 炎症反应综合征 白细胞介素-6 白细胞介素-10 白细胞介素-19 

分 类 号：R714[医药卫生—妇产科学]