胎膜早破产妇血清HMGB1、NLRC5水平变化及对组织学绒毛膜羊膜炎的预测价值  

Changes in Serum HMGB1 and NLRC5 Levels in Pregnant Women with Premature Rupture of Membranes and Their Predictive Value for Histolog⁃ical Chorioamnionitis

作　　者：鲁俊 刘永红 LU Jun;LIU Yonghong(Department of Obstetrics and Gynecology,Beijing Electric Power Hospital,Beijing,100071,China)

机构地区：[1]北京电力医院妇产科,北京100071

出　　处：《转化医学杂志》2024年第7期1085-1089,共5页Translational Medicine Journal

基　　金：中华国际科学交流会(Z2020LBJ003)。

摘　　要：目的探讨胎膜早破产妇血清高迁移率族蛋白B1(HMGB1)、NOD样受体家族含半胱天冬酶激活和募集域结构域5(NLRC5)水平变化及对组织学绒毛膜羊膜炎(HCA)的预测价值。方法选取2021年1月至2024年1月北京电力医院妇产科收治的胎膜早破孕妇198例(胎膜早破组)和正常妊娠孕妇55例(对照组),根据是否发生HCA将胎膜早破孕妇分为HCA组(77例)和非HCA组(121例)。采用酶联免疫吸附法检测血清HMGB1、NLRC5水平。多因素Logistic回归分析胎膜早破孕妇HCA的因素,ROC分析血清HMGB1、NLRC5水平对胎膜早破孕妇HCA的预测价值。结果胎膜早破组血清HMGB1、NLRC5水平高于对照组,差异有统计学意义(P<0.05)。胎膜早破发生孕周延长为胎膜早破孕妇HCA的独立保护因素,降钙素原、C反应蛋白、HMGB1、NLRC5升高为独立危险因素(P<0.05)。血清HMGB1联合NLRC5预测胎膜早破孕妇HCA的曲线下面积为0.862,大于血清HMGB1、NLRC5水平单独预测的0.755、0.761(P<0.05)。结论胎膜早破产妇血清HMGB1、NLRC5水平升高,是HCA发生的独立危险因素,血清HMGB1联合NLRC5对胎膜早破孕妇HCA的预测价值较高。Objective To explore the changes in serum levels of High Mobility Group Box 1(HMGB1)and NOD⁃like receptor family caspase activation and recruitment domain containing 5(NLRC5)in pregnant women with premature rup⁃ture of membranes(PROM)and their predictive value for histological chorioamnionitis(HCA).Methods A total of 198 pregnant women with PROM admitted to department of obstetrics and gynecology,Beijing electric power hospital from January 2021 to January 2024 were selected(PROM group)alongside 55 normal pregnant women(control group).Based on the oc⁃currence of HCA,PROM patients were divided into HCA group(77 cases)and non⁃HCA group(121 cases).Serum levels of HMGB1 and NLRC5 were measured using enzyme⁃linked immunosorbent assay(ELISA).Multivariate logistic regression anal⁃ysis was performed to identify factors associated with HCA in PROM patients,and ROC curve analysis was conducted to evalu⁃ate the predictive value of serum HMGB1 and NLRC5 levels for HCA in PROM patients.Results Compared with the control group,serum levels of HMGB1 and NLRC5 were significantly elevated in the PROM group(P<0.05).Prolonged gestational age at PROM was identified as an independent protective factor against HCA,while elevated procalcitonin,C⁃reactive protein,HMGB1,and NLRC5 were independent risk factors(P<0.05).The area under the ROC curve for predicting HCA in PROM patients using both HMGB1 and NLRC5 was 0.862,which was higher than the separate predictions of 0.755 and 0.761 for HMGB1 and NLRC5,respectively(P<0.05).Conclusion Elevated serum levels of HMGB1 and NLRC5 in PROM pa⁃tients are independent risk factors for the occurrence of HCA,and the combined use of serum HMGB1 and NLRC5 demon⁃strates high predictive value for HCA in pregnant women with PROM.

关 键 词：胎膜早破 高迁移率族蛋白B1 NOD样受体家族含半胱天冬酶激活和募集域结构域5 组织学绒毛膜羊膜炎 预测价值 

分 类 号：R714[医药卫生—妇产科学]