血清sTLR4、IL-22 R1、PAF与胎膜早破合并绒毛膜羊膜炎及早发型败血症的关系  

Relationship of serum sTLR4,IL⁃22 R1,PAF with premature rupture of fetal membrane complicated with chorionic amniotic inflammation and early onset sepsis

作　　者：张静华 尤小燕 李瓅 ZHANG Jinghua;YOU Xiaoyan;LI Li(Obstetrics and Gynecology Department of Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州大学附属郑州中心医院妇产科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2024年第7期1276-1280,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(2018020780)。

摘　　要：目的 探讨血清可溶性Toll样受体4(sTLR4)、白介素22受体1(IL-22R1)、血小板激活因子(PAF)水平在胎膜早破合并绒毛膜羊膜炎(CAM)中的变化及对早发型败血症(EONS)的预测价值。方法 选择郑州大学附属郑州中心医院妇产科的122例胎膜早破的产妇作为研究对象,根据胎盘病理结果为CAM组与非CAM组,分析sTLR4、IL-22 R1、PAF水平在胎膜早破合并绒毛膜羊膜炎中的变化;根据随访结果分为EONS组与非EONS组,分析sTLR4、IL-22 R1、PAF水平对EONS发生的预测价值。结果122例胎膜早破产妇中有46例合并CAM,发生率为37.70%,有76例产妇未合并CAM,占62.30%。CAM组WBC、PLT、CRP、sTLR4、IL-22 R1、PAF水平均高于非CAM组,差异有统计学意义(t=23.063、15.534、17.763、8.988、12.588、6.352,P<0.05)。多因素logistic回归分析显示:IL-22 R1、PAF水平增高与胎膜早破合并CAM发生密切相关(P<0.05)。122例胎膜早破产妇中有16例发生EONS,发生率为13.11%,有106例产妇未发生EONS,占86.89%。EONS组CAM比例、sTLR4、IL-22 R1、PAF水平均高于非EONS组,差异有统计学意义(χ^(2)=4.820,t=6.935、4.938、3.577,P<0.05)。多因素logistic回归分析显示:CAM及sTLR4、IL-22 R1水平增高与胎膜早破产妇发生EONS密切相关(P<0.05)。sTLR4、IL-22 R1、PAF三者联合预测的AUC为0.851(0.770~0.933),灵敏度为81.3%,特异度为79.2%,高于单一检测(P<0.05)。结论 血清sTLR4、IL-22 R1、PAF在胎膜早破合并CAM中明显增高,与CAM及EONS发生密切相关,三指标联合检测对EONS发生有良好的临床预测价值。Objective To investigate the changes of serum soluble Toll-like receptor 4(sTLR4),interleukin 22 receptor 1(IL-22R1)and platelet activation factor(PAF)levels in premature rupture of mem-branes with chorioamnionitis(CAM)and the predictive value for early onset neonatal sepsis(EONS).Methods A total of 122 parturients with PROM of Obstetrics and Gynecology Department of Zhengzhou Cen-tral Hospital Affiliated to Zhengzhou University were retrospectively selected as the research subjects.The par-ticipants were divided into two groups:the CAM group and the non-CAM group based on the pathological re-sults of placenta.The changes of sTLR4,IL-22 R1 and PAF levels were analyzed in PROM combined with cho-rioamnionitis.Additionally,the rats were divided into the EONS group and the non-EONS group based on the follow-up results,and the predictive value of sTLR4,IL-22 R1 and PAF levels on the occurrence of EONS was analyzed.Results Forty-six out of 122 parturients with PROM were complicated with CAM,and the inci-dence rate was 37.70%.Seventy-six parturients without CAM accounted for 62.30%.The levels of WBC,PLT,CRP,sTLR4,IL-22 R1 and PAF in the CAM group were higher than those in the non-CAM group,the differ-ence had statistical significance(t=23.063,15.534,17.763,8.988,12.588,6.352,P<0.05).Multivariate logis-tic regression analysis showed that the increase in IL-22 R1 and PAF levels is closely related to the occurrence of premature rupture of membranes combined with CAM(P<0.05).Among the 122 cases of premature rupture of membranes,16 cases(13.11%)experienced EONS,and 106 cases(86.89%)did not experience EONS.The levels of CAM proportion,sTLR4,IL-22 R1 and PAF in the EONS group were higher than those in the non-EONS group,the difference had statistical significance(χ^(2)=4.820,t=6.935,4.938,3.577,P<0.05).Multi-variate logistic regression analysis showed that the increase in CAM,sTLR4 and IL-22 R1 levels were closely related to EONS in women with premature rupture of membranes(P<0.05).The combined ROC-AUC was 0.851(0.770~0.933),

关 键 词：可溶性Toll样受体4 白介素22受体1 血小板激活因子 胎膜早破 绒毛膜羊膜炎 早发型败血症 

分 类 号：R714.433[医药卫生—妇产科学]