胎膜早破并发羊膜腔感染孕妇Cav-1/NF-κB信号通路及妊娠结局  

Cav-1/NF-κB signaling pathways in premature rupture of membrane pregnant women complicated with intraamniotic infection and pregnancy outcomes

作　　者：杜娟[1] 王瀚[1] 孟红娟[1] 朱一麟[1] 高雪梅[1] DU Juan;WANG Han;MENG Hong-juan;ZHU Yi-lin;GAO Xue-mei(Wuhan No.1 Hospital,Wuhan,Hubei 430000,China)

机构地区：[1]武汉市第一医院产科,湖北武汉430000

出　　处：《中华医院感染学杂志》2023年第9期1408-1412,共5页Chinese Journal of Nosocomiology

基　　金：武汉市卫生健康委科研项目(WX16C34)。

摘　　要：目的观察胎膜早破(PROM)并发羊膜腔感染孕妇小窝蛋白-1(Cav-1)/核因子-κB(NF-κB)信号通路变化及其对妊娠结局的影响。方法收集2018年1月-2019年12月武汉市第一医院236例PROM孕妇临床资料,根据并发羊膜腔感染情况分为感染组65例与非感染组171例,检测胎膜组织Cav-1、NF-κB、蛋白激酶B(Akt)、Toll样受体4(TLR-4)相对表达量及血清白细胞介素-6(IL-6)、C-反应蛋白(CRP)、基质金属蛋白酶-2(MMP-2)、β2防御素(HBD-2)水平,分析两组孕妇妊娠结局差异。结果感染组胎龄、新生儿出生体质量均低于非感染组(P<0.05),感染组下生殖道感染率、剖宫产率、产褥感染率及新生儿感染率均显著高于非感染组(P<0.05);感染组胎膜组织Cav-1、NF-κB、Akt、TLR-4 mRNA相对表达量及血清IL-6、CRP、MMP-2、HBD-2水平均显著高于非感染组(P<0.05);Cav-1、NF-κB、Akt、TLR-4 mRNA相对表达量及血清IL-6、CRP、MMP-2、HBD-2水平随感染程度加重逐渐升高(P<0.05)。结论PROM并发羊膜腔感染可引起剖宫产、产褥感染及新生儿感染等不良妊娠结局,Cav-1/NF-κB信号通路可能参与羊膜腔感染的发生与发展。OBJECTIVE To observe the changes of caveolin-1(Cav-1)/nuclear factor-κB(NF-κB)signaling pathways in premature rupture of membranes(PROM)pregnant women complicated with intraamniotic infection and analyze the effect on pregnancy outcomes.METHODS The clinical data were collected from 236 PROM pregnant women who were treated in Wuhan No.1 Hospital from Jan 2018 to Dec 2019,the patients were divided into the infection group with 65 cases and the non-infection group with 171 cases according to the status of intraamniotic infection.The relative expression levels of Cav-1,NF-κB,protein kinase B(Akt)and Toll-like receptor 4(TLR-4)in fetal membrane tissues and the levels of serum interleukin-6(IL-6),C-reactive protein(CRP),matrix metalloproteinase-2(MMP-2)andβ2 defensin(HBD-2)were detected.The pregnancy outcomes were observed and compared between the two groups.RESULTS The gestational age and neonatal birth weight of the infection group were lower than those of the non-infection group(P<0.05).The incidence of lower genital tract infection,rate of cesarean section,incidence of puerperal infection and incidence of neonatal infection were remarkably higher in the infection group than in the non-infection group(P<0.05).The relative expression levels of Cav-1,NF-κB,Akt and TLR-4 mRNA in fetal membrane tissues and levels of serum IL-6,CRP,MMP-2 and HBD-2 were remarkably higher in the infection group than in the non-infection group(P<0.05).The relative expression levels of Cav-1,NF-κB,Akt and TLR-4 mRNA and levels of serum IL-6,CRP,MMP-2 and HBD-2 were elevated with the exacerbation of infection(P<0.05).CONCLUSION PROM complicated with intraamniotic infection may induce the adverse pregnancy outcomes such as cesarean section,puerperal infection and neonatal infection.Cav-1/NF-κB signaling pathways may be involved in the occurrence and development of the intraamniotic infection.

关 键 词：胎膜早破 羊膜腔感染 小窝蛋白-1 核因子-κB 妊娠结局 

分 类 号：R714.433[医药卫生—妇产科学]