NLRP3炎症小体在胎膜早破孕妇血清中的表达及其意义  

Expression and significance of NLRP3 inflammasome in serum of pregnant women with premature rupture of membranes

作　　者：黄蓉 梁自毓 祁文瑾[1] Rong Huang;Ziyu Liang;Wenjin Qi(Department of Obstetrics,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,Yunan Province,China)

机构地区：[1]昆明医科大学第一附属医院产科,昆明650032

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第5期540-548,共9页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金项目(82260302);云南省教育厅教师类项目(2022J0242)。

摘　　要：目的探讨核苷酸结合寡聚化结构域样受体蛋白(NLRP)3炎症小体在未足月胎膜早破(PPROM)与足月胎膜早破(TPROM)孕妇血清中的表达水平及意义。方法选择2022年4月至12月于昆明医科大学第一附属医院住院分娩的53例胎膜早破(PROM)孕妇为研究对象,纳入PROM组。再根据发生PROM时孕妇孕龄,将PROM组进一步分为PPROM亚组(n=15)与TPROM亚组(n=38)。选择同期于本院正常足月分娩的21例孕妇纳入对照组(n=21)。本研究获得昆明医科大学第一附属医院医学伦理委员会的批准(批准文号:2021-10-18),并与所有受试者签署临床研究知情同意书。采用酶联免疫吸附测定(ELISA)法,分别测定所有受试者入院时及PROM组发生PROM后12、24、36 h时,血清NLRP3炎症小体,包括NLRP3、衔接分子凋亡相关斑点样蛋白(ASC)、半胱氨酸天冬氨酸特异性蛋白酶(caspase)-1水平,采用Kruskal-Wallis H秩和检验进行PPROM亚组、TPROM亚组及对照组3组比较,进一步两两比较采用Mann-Whitney U检验,并采用Bonferroni法调整P值。收集PROM组与对照组母儿预后相关指标,采用成组t检验、Wilcoxon秩和检验、χ^(2)检验进行统计学比较。PPROM亚组、TPROM亚组与对照组孕妇年龄、分娩前人体质量指数(BMI)、孕次、初产妇占比等一般临床资料分别比较,差异均无统计学意义(P>0.05)。结果①PROM组孕妇绒毛膜羊膜炎发生率、产程中最高体温及分娩出血量,均显著高于对照组,并且差异均有统计学意义(χ^(2)=15.57、P<0.001,t=8.18、P<0.001,T=738.50、P=0.027)。PROM组新生儿转入新生儿科比例、感染发生率及生后12 h白细胞计数(WBC),均显著高于对照组(χ^(2)=6.91、P=0.009,χ^(2)=11.04、P=0.001,t=3.52、P=0.004)。②PPROM亚组、TPROM亚组及对照组孕妇入院时血清NLRP3炎症小体(NLRP3、ASC、caspase-1)水平分别比较,差异均有统计学意义(H=77.00、48.42、83.36,P<0.001)。进一步两两比较结果显示,PPROM亚组、TPROMObjective To investigate the expression and significance of nucleotide binding oligomerization domain-like receptor protein(NLRP)3 inflammasome in the serum of pregnant women with preterm premature rupture of membranes(PPROM)and term premature rupture of membranes(TPROM).Methods A total of 53 pregnant women with premature rupture of membranes(PROM)who delivered in the First Affiliated Hospital of Kunming Medical University from April to December 2022 were selected as research objects,and included into PROM group.According to PROM group pregnant women&apos;s gestational age,they were further divided into PPROM subgroup(n=15)and TPROM subgroup(n=38).Twenty-one pregnant women with normal full-term delivery in our hospital during the same period were selected as the control group(n=21).This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Kunming Medical University(Approval No.2021-10-18),and clinical research informed consents were obtained from all the participants.Enzyme-linked immunosorbent assay(ELISA)was used to measure the serum levels of NLRP3 inflammasome,including NLRP3,apoptosis-associated speck-like protein containing a CARD(ASC)and cysteinyl aspartate specific proteinase(caspase)-1 at admission and 12,24,and 36 h after PROP,and Kruskal-Wallis H rank sum test was used for comparison among two subgroups and control group,and Mann-Whitney U test was used for further pairwise comparison,and Bonferroni method was used to adjust P values.The related indicators of maternal and neonatal prognosis between PROM group and control group were compared by independent-samples t test,Wilcoxon rank sum test,and chi-square test.There were no significant differences in general clinical data such as age,body mass index(BMI)before delivery,gravidity,and the proportion of primiparas among two subgroups and control group(P>0.05).Results①The incidence of chorioamnionitis,the highest body temperature during labor and the amount of bleeding during labor in PROM group were significantly high

关 键 词：胎膜早破 NLRP3 炎症小体 半胱氨酸天冬氨酸蛋白酶1 炎性体 细胞焦亡 早产 绒毛膜羊膜炎 孕妇 

分 类 号：R714[医药卫生—妇产科学]