摘要
目的:探讨未足月胎膜早破(PPROM)新生儿脐血单核细胞趋化蛋白-1(MCP-1)、肾上腺髓质素前体(pro-ADM)水平与绒毛膜羊膜炎(CAM)的相关性。方法:选取296例PPROM产妇作为PPROM组(A),同期100例足月胎膜早破(TPROM)产妇作为TPROM组(B),同期100例正常足月产妇作为对照组;比较3组产妇及新生儿的临床资料(年龄、孕次、孕期、分娩方式及新生儿出生时Apgar评分)及妊娠结局(产后出血、产褥感染,胎儿窘迫、新生儿窒息、发育畸形及极低出生体重)、3组产妇Ⅰ~Ⅲ期的CAM发生率;比较PPROM组发生CAM新生儿脐带血MCP-1、pro-ADM水平,采用Spearman等级法分析PPROM新生儿脐带血MCP-1、pro-ADM水平与CAM分期的相关性。结果:PPROM组产妇的孕期和新生儿出生时Apgar评分均低于TPROM组和对照组(P <0. 05),PPROM组产妇的剖宫产比例及胎儿窘迫、新生儿窒息、极低体重儿发生率均高于TPROM组和对照组(P<0. 05),PPROM组和TPROM组产妇的产褥感染发生率均高于对照组(P <0. 05);PPROM组产妇的CAM发生率高于TPROM组和对照组,差异均有统计学意义(P <0. 05);在PPROM组中,发生CAM新生儿脐带血MCP-1、pro-ADM水平高于未发生CAM新生儿(P <0. 05),且随着CAM分期的升高而新生儿脐带血MCP-1、pro-ADM水平也逐渐上升(P <0. 05);Spearman等级相关分析结果显示,新生儿脐带血MCP-1、pro-ADM水平与CAM分期均呈正相关关系(r_s=0. 823、0. 716,P <0. 05)。结论:PPROM可导致产妇和新生儿的不良结局及CAM的增加,发生CAM的PPROM新生儿脐带血中MCP-1、pro-ADM水平高于未发生CAM的新生儿,且其水平与CAM的分期呈正相关关系。
Objective:To analyze the correlation between monocyte chemoattractant protein-1(MCP-1),pro-adrenomedullin(pro-ADM)levels of cord blood and chorioamnionitis(CAM)in neonates with preterm premature rupture of the membranes(PPROM).Methods:296 lying-in women with PPROM were selected as Group A,100 lying-in women with term premature rupture of membranes(TPROM)as Group B,and 100 normal term lying-in women as the control group.The clinical data,the pregnancy outcome as well as the incidence and stages of CAM among the lying-in women in the three groups were investigated and compared.The serum MCP-1 and pro-ADM levels in the cord blood of the neonates in Group A were detected.Results:The pregnancy course of the lying-in women and the Apgar scores 1min after birth of the neonates in Group A were lower than those of Group B and the control group,and the difference was statistically significant(P<0.05).The incidences of cesarean section,fetal distress,neonatal asphyxia and very low birth weight were higher than those of Group B and the control group,while the incidence of puerperal infection of Group A and Group B was higher than that of the control group.The difference was statistically significant(P<0.017).The incidence of CAM in Group A was higher than that in Group B and the control group.The difference was statistically significant(P<0.017),while the difference of CAM stage distribution of all the groups was statistically significant(P<0.05).In Group A,the levels of MCP-1 and pro-ADM in cord blood of neonates with CAM were higher than those of neonates without CAM,the difference was statistically significant(P<0.05).With the increase of CAM stage,the levels of MCP-1 and pro-ADM in cord blood of neonates increased gradually.(P<0.05).The results of Spearman rank correlation analysis showed that the levels of MCP-1 and pro-ADM in cord blood were positively correlated with CAM stage(r s=0.823,0.716,P<0.05).Conclusions:PPROM can lead to adverse outcome and increase of CAM in the lying-in women and neonates.The levels of MCP-
作者
李惠
李秋红
赵越
LI Hui;LI Qiuhong;ZHAO Yue(Department of Obstetrics,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao,066000,Hebei,China)
出处
《贵州医科大学学报》
CAS
2020年第6期727-732,共6页
Journal of Guizhou Medical University
基金
秦皇岛市科学技术局基金项目(201703A123)。
关键词
早产
胎膜早破
绒毛膜羊膜炎
单核细胞趋化蛋白-1
肾上腺髓质素前体
premature birth
fetal membranes
premature rupture
chorioamnionitis(CAM)
monocyte chemoattractant protein-1(MCP-1)
pro-adrenomedullin(pro-ADM)
