胎膜早破合并绒毛膜羊膜炎病原菌及NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA与病情进展的关联  

Pathogenic bacteria of premature rupture of membranes complicated with chorioamnionitis and association of NLRC5 mRNA TLR-4 mRNA,Caspase-1 mRNA with disease progression

作　　者：申淑玲 王群 王红梅 苏慧芳 王超 SHEN Shu-ling;WANG Qun;WANG Hong-mei;SU Hui-fang;WANG Chao(Shandong First Medical University Affiliated People's Hospital,Jinan,Shandong 271199,China)

机构地区：[1]山东第一医科大学附属人民医院产科,山东济南271199

出　　处：《中华医院感染学杂志》2024年第19期2983-2988,共6页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2017WS137)。

摘　　要：目的分析胎膜早破(PROM)合并绒毛膜羊膜炎(CAM)病原菌及核苷酸结合寡聚化结构域样受体5(NLRC5)mRNA、Toll样受体-4(TLR-4)mRNA、半胱天冬酶-1(Caspase-1)mRNA表达与病情进展的关联。方法选取山东第一医科大学附属人民医院2021年1月-2023年5月收治的178例PROM孕妇根据分娩时胎膜组织病理结果分为CAM组(82例)、非CAM组(96例),统计PROM合并CAM患者检出病原菌,比较两组胎膜组织NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA表达水平,采用受试者工作特征(ROC)曲线分析胎膜组织NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA对PROM患者合并CAM的诊断价值;将PROM合并CAM患者按照炎症程度分为轻度组(26例)、中度组(29例)、重度组(27例),比较不同炎症程度患者胎膜组织NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA表达水平,分析胎膜组织NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA与PROM合并CAM患者病情的相关性。结果82例PROM合并CAM患者共培养分离病原菌97株,以大肠埃希菌、粪肠球菌为主;CAM组胎膜组织NLRC5 mRNA、TLR-4 mRNA和Caspase-1 mRNA分别为1.54±0.51、15.86±4.79和1.48±0.47均高于非CAM组(P<0.05);胎膜组织NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA联合诊断PROM患者合并CAM的曲线下面积(AUC)值高于三者单独检测(P<0.05);轻度组、中度组、重度组胎膜组织NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA水平呈升高趋势(P<0.05);胎膜组织NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA与PROM合并CAM患者病情程度呈正相关(r=0.563、0.618、0.537,P均<0.05)。结论PROM合并CAM患者主要感染病原菌种类为大肠埃希菌和粪肠球菌,NLRC5 mRNA、TLR-4 mRNA、Caspase-1 mRNA联合对PROM患者合并CAM具有较好的诊断价值,同时三者表达水平与患者病情程度密切相关。OBJECTIVE To analyze the pathogenic bacteria of premature rupture of membranes(PROM)complicated with chorioamnionitis(CAM)and association of the expression of messenger RNA(mRNA)of nucleotide-binding oligomerization domain-like receptor 5(NLRC5),Toll-like receptor-4(TLR-4)and caspase-1 mRNA with the progress of the disease.METHODS A total of 178 cases of pregnant women with PROM admitted to the People's Hospital affiliated to Shandong First Medical University from Jan.2021 to May 2023 were selected and divided into CAM group(82 cases)and non-CAM group(96 cases)according to the histologic findings of the fetal membrane tissues at the time of delivery.The pathogenic bacteria detected in patients with PROM complicated with CAM were counted,and the expression levels of NLRC5,TLR-4 and Caspase-1 mRNA in fetal membrane tissue of the two groups were compared,and receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of NLRC5,TLR-4 and Caspase-1 mRNA in fetal membranes in patients with CAM.According to the degree of inflammation,PROM patients with CAM were divided into mild group(26 cases),moderate group(29 cases)and severe group(27 cases).The expression levels of NLRC5,TLR-4 and Caspase-1 mRNA in fetal membranes of patients with different degrees of inflammation were compared,and the correlation between NLRC5,TLR-4 and Caspase-1 mRNA in fetal membranes and the condition of PROM patients with CAM was analyzed.RESULTS A total of 97 strains of pathogenic bacteria were isolated from 82 patients with PROM and CAM,mainly Escherichia coli and Enterococcus faecalis.The NLRC5 mRNA,TLR-4 mRNA,and Caspase-1 mRNA in the CAM group were 1.54±0.51,15.86±4.79,and 1.48±0.47,respectively,higher than those in the non-CAM group(P<0.05).The area under the curve(AUC)of fetal membrane NLRC5 mRNA,TLR-4 mRNA and Caspase-1 mRNA combined for diagnosis of PROM patients complicated with CAM was higher than that of the three tests alone(P<0.05).The levels of NLRC5 mRNA,TLR-4 mRNA and Caspase-1 mRNA in fetal membranes

关 键 词：胎膜早破 绒毛膜羊膜炎 病原菌 核苷酸结合寡聚化结构域样受体5 mRNA Toll样受体-4 mRNA 半胱天冬酶-1 mRNA 病情程度 相关性 

分 类 号：R714.433[医药卫生—妇产科学]