细胞焦亡相关蛋白在胎膜早破孕妇胎膜组织中的表达及其与妊娠结局的关系  

Expression of pyroptosis related proteins in fetal membranes of pregnant women with premature rupture of membranes and its relationship with pregnancy outcome

作　　者：钱云英[1] 钱桂英[2] 蔡奚梅 顾伟群 倪海燕[1] 朱丹婴 徐英芳[1] 计文霞 QIAN Yunying;QIAN Guiying;CAI Ximei;GU Weiqun;NI Haiyan;ZHU Danying;XU Yingfang;JI Wenxia(Department of Gynaecology and Obstetrics,Changshu Traditional Chinese Medicine Hospital,Jiangsu Changshu 215500,China;Department of Pharmacy,Changshu Traditional Chinese Medicine Hospital,Jiangsu Changshu 215500,China)

机构地区：[1]常熟市中医院妇产科,江苏常熟215500 [2]常熟市中医院药剂科,江苏常熟215500

出　　处：《江苏大学学报（医学版）》2024年第4期283-289,306,共8页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:探究细胞焦亡相关蛋白半胱氨酸天冬氨酸特异性蛋白酶-1(cysteinyl aspartate specific proteinase,Caspase-1)和核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)在胎膜早破孕妇胎膜组织中的表达及其与妊娠结局的关系。方法:选择2020年1月至2023年1月于常熟市中医院妇产科就诊并分娩的胎膜早破孕妇135例作为观察组,另选择同期产检并分娩的健康孕妇135例作为对照组,比较两组孕妇胎膜组织中NLRP3 mRNA和Caspase-1 mRNA表达。依据妊娠结局将135例胎膜早破孕妇分为妊娠不良组(n=50)和妊娠良好组(n=85),通过单因素和多因素Logistic分析胎膜早破孕妇妊娠不良的独立危险因素;应用Logistic回归模型结合限制性立方样条(restricted cubic splines,RCS)分析胎膜早破孕妇胎膜组织中细胞焦亡相关蛋白表达量与妊娠不良的剂量反应关系;依据独立因素构建列线图预测模型,并对模型进行验证。结果:观察组胎膜组织中NLRP3 mRNA和Caspase-1 mRNA表达显著高于对照组(P<0.001)。就诊时间≥2 h、生殖道感染、NLRP3 mRNA和Caspase-1 mRNA高表达是胎膜早破孕妇妊娠结局不良的独立危险因素(P<0.05);RCS结果显示,胎膜早破孕妇胎膜组织中NLRP3 mRNA、Caspase-1 mRNA表达量与妊娠结局不良呈非线性剂量反应关系,在NLRP3 mRNA表达量为1.20(OR=1.818,95%CI:1.673~1.932)和Caspase-1 mRNA表达量为1.25(OR=2.735,95%CI:1.132~3.821)处发生妊娠结局不良的风险最大;构建的列线图预测模型具有良好的区分度、准确性和临床适用性。结论:NLRP3 mRNA和Caspase-1 mRNA在胎膜早破孕妇胎膜组织中呈高表达,二者是胎膜早破孕妇妊娠结局不良的独立危险因素,随着表达量升高,胎膜早破孕妇妊娠不良的危险性也随之升高。Objective:To explore the expression of pyroptosis related protein cysteinyl aspartate specific proteinase-1(Caspase-1)and nucleotide-binding oligomerization domain-like receptor protein-3(NLRP3)in fetal membranes of pregnant women with premature rupture of membranes(PROM)and their relationship with pregnancy outcomes.Methods:A total of 135 pregnant women with PROM who received medical treatment and delivered at the Obstetrics and Gynecology Department of Changshu Traditional Chinese Medicine Hospital from January 2020 to January 2023 were selected as the observation group,and other 135 healthy pregnant women who received prenatal examination and delivered during the same period were selected as the control group.The expression of NLRP3 mRNA and Caspase-1 mRNA in the fetal membrane tissue of the two groups of pregnant women was compared.One hundred and thirty-five pregnant women with PROM were divided into a poor pregnancy group(n=50)and a good pregnancy group(n=85)based on pregnancy outcomes.Independent risk factors for poor pregnancy in pregnant women with PROM were analyzed using univariate and multivariate Logistic analysis.Logistic regression model and restricted cubic splines(RCS)were used to analyze the dose-response relationship between the expression of pyroptosis related proteins in fetal membranes of pregnant women with PROM and adverse pregnancy.A nomogram prediction model was constructed by using independent influencing factors and the model was also verified.Results:The expression of NLRP3 mRNA and Caspase-1 mRNA in the fetal membrane tissue of the observation group was significantly higher than that of the control group(P<0.001).Visit time,reproductive tract infections,and the mRNA expression levels of NLRP3 and Caspase-1 are independent risk factors for poor pregnancy outcomes in pregnant women with PROM(P<0.05).The RCS results showed that the expression levels of NLRP3 and Caspase-1 in the fetal membrane tissue of pregnant women with PROM showed a non-linear dose-response relationship with adverse

关 键 词：细胞焦亡相关蛋白 半胱氨酸天冬氨酸特异性蛋白酶-1 核苷酸结合寡聚化结构域样受体蛋白3 胎膜早破 胎膜组织 妊娠结局 

分 类 号：R737.31[医药卫生—肿瘤]