未足月胎膜早破合并羊膜腔感染危险因素及外周血miR-182、miR-200、miR-21的预测价值  

Risk factors for amniotic cavity infection in patients with preterm premature rupture of membranes and predictive values of peripheral blood miR-182,miR-200 and miR-21

作　　者：雷焕 何娅 曾楚迪 张强 LEI Huan;HE Ya;ZENG Chu-di;ZHANG Qiang(Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义医科大学附属医院产科,贵州遵义563000

出　　处：《中华医院感染学杂志》2023年第13期2056-2060,共5页Chinese Journal of Nosocomiology

基　　金：遵义市科技计划基金资助项目[遵市科合HZ字(2021)52号]。

摘　　要：目的研究未足月胎膜早破合并羊膜腔感染危险因素及外周血微小RNA(miR)-182、miR-200、miR-21的预测价值。方法回顾性收集2018年1月-2022年7月遵义医科大学附属医院收治的1500例未足月胎膜早破患者临床资料,根据是否发生羊膜腔感染分为感染组174例和未感染组1326例,采用多因素Logistic回归分析未足月胎膜早破患者合并羊膜腔感染的危险因素,采用受试者工作特征(ROC)曲线分析外周血miR-182、miR-200、miR-21对未足月胎膜早破患者合并羊膜腔感染的预测价值。结果感染组外周血miR-182、miR-200、miR-21水平高于未感染组(P<0.05)。外周血miR-182、miR-200、miR-21水平及下生殖道感染、羊水过少、多胎妊娠、合并妊娠期糖尿病、阴道清洁度均为未足月胎膜早破患者合并羊膜腔感染的危险因素(P<0.05)。外周血miR-182、miR-200、miR-21联合检测预测未足月胎膜早破患者合并羊膜腔感染的曲线下面积、敏感度均高于三者单独检测(P<0.05)。结论外周血miR-182、miR-200、miR-21联合对未足月胎膜早破患者合并羊膜腔感染具有较好的预测价值,此外其危险因素包括下生殖道感染、羊水过少、多胎妊娠、合并妊娠期糖尿病、阴道清洁度Ⅲ~Ⅳ度。OBJECTIVE To explore the risk factors for amniotic cavity infection in the patients with preterm premature rupture of membranes(PROM)and analyze the predictive values of peripheral blood microRNA-182(miR-182),microRNA-200(miR-200)and microRNA-21(miR-21).METHODS A total of 1500 patients with preterm PROM who were treated in the Affiliated Hospital of Zunyi Medical University from Jan 2018 to Jul 2022 were recruited as the research subjects and were divided into the infection group with 174 cases and the no infection group with 1325 cases according to the status of amniotic cavity infection.The clinical data were retrospectively collected from the patients.Multivariate logistic regression analysis was performed for the risk factors for the amniotic cavity infection in the patients with preterm PROM.The values of peripheral blood miR-182,miR-200 and miR-21 in prediction of amniotic cavity infection were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of peripheral blood miR-182,miR-200 and miR-21 of the infection group were significantly higher than those of the no infection group(P<0.05).The peripheral blood miR-182,miR-200,miR-21,genital tract infection,oligohydramnios,multiple pregnancies,gestational diabetes mellitus and vaginal cleanliness degree were the risk factors for the amniotic cavity infection in the patients with preterm PROM(P<0.05).The area under curve and sensitivity of the joint detection of the peripheral blood miR-182,miR-200 and miR-21 were significantly higher in prediction of the amniotic cavity infection than those of the single detection of three indexes(P<0.05).CONCLUSION The joint detection of peripheral blood miR-182,miR-200 and miR-21 has high value in prediction of the amniotic cavity infection in the patients with preterm PROM.The risk factors for the infection include genital tract infection,oligohydramnios,multiple pregnancies,gestational diabetes mellitus and vaginal cleanliness degree ranging between Ⅲ and Ⅳ.

关 键 词：未足月胎膜早破 羊膜腔感染 微小RNA-182 微小RNA-200 微小RNA-21 危险因素 

分 类 号：R714.433[医药卫生—妇产科学]