摘要
目的探讨未足月胎膜早破(PPROM)患者血清和胎盘中可溶性髓系细胞触发受体-1(sTREM-1)及炎症介质TNF-α、IL-1β与绒毛膜羊膜炎(CA)的相关性,为疾病早期诊断提供敏感性标志物。方法收集2021年3月至2023年9月金华市中心医院收治的84例PPROM患者,平均孕周为(34.5±2.3)周。根据胎盘病理检查结果分为CA组40例和无CA组44例,并选择同期年龄和孕周匹配的正常妊娠者40例作为对照组。ELISA法检测产前孕妇血清sTREM-1、TNF-α和IL-1β水平,检查血液WBC、粒细胞百分比、CRP和降钙素原(PCT),Western blot法检测产后胎盘中sTREM-1、TNF-α和IL-1β蛋白相对表达量。分析血清和胎盘中各项检测指标的相关性。绘制ROC曲线,分析血清s TREM-1诊断PPROM和CA的效能。结果CA组血清sTREM-1、TNF-α、IL-1β、CRP和PCT水平均显著高于无CA组和对照组,无CA组sTREM-1、TNF-α和IL-1β水平均显著高于对照组(均P<0.05)。CA组胎盘sTREM-1、TNF-α和IL-1β蛋白相对表达量均显著高于无CA组(均P<0.05)。胎盘sTREM-1、TNF-α、IL-1β蛋白相对表达量与血清s TREM-1、TNF-α、IL-1β水平均两两呈正相关(均P<0.001)。血清sTREM-1、TNF-α和IL-1β诊断PPROM的AUC分别为0.916、0.785和0.815(均P<0.05);血清sTREM-1诊断CA的AUC为0.935(P<0.05)。结论PPROM患者血清s TREM-1升高可作为疾病诊断和CA评估的重要血清生化标志物。
Objective To investigate the relationship between soluble triggering receptor expressed on myeloid cell-1(sTREM-1)and inflammatory mediator TNF-αand IL-1βin serum and placenta tissues of patients with preterm premature rupture of membranes(PPROM)and chorioamnionitis(CA)so as to provide sensitive biomarkers for early diagnosis of disease.Methods A total of 84 patients with PPROM diagnosed in Jinhua Municipal Central Hospital from March 2021 to September 2023 were included,with average gestational age of(34.5±2.3)weeks.According to placental pathology,there were 40 cases in CA group and 44 cases in non-CA group.Another 40 normal pregnant women matched in age and gestational age were selected as the control group.ELISA method was used to detect serum sTREM-1 and TNF-αand IL-1βin prenatal pregnant women,and routine blood biochemical indicators included WBC and neutrophil percentage,CRP and procalcitonin(PCT)were examined.Western blot method was used to detect sTREM-1,TNF-αand IL-1βproteins relative expressions in postpartum placenta.The relationship between various indicators in serum and placenta and CA were analyzed.ROC curve was drawn to analyze the efficacy of serum sTREM-1 in diagnosing PPROM and CA.Results Serum sTREM-1,TNF-α,IL-1β,CRP and PCT levels in CA group were significantly higher than those of non-CA group and control group,and sTREM-1,TNF-αand IL-1βlevels in non-CA group were higher than those of the control group(all P<0.05).The placenta sTREM-1,TNF-αand IL-1βproteins relative expressions in CA group were significantly higher than those of non-CA group(all P<0.05).Spearman test showed that placental sTREM-1,TNF-αand IL-1βproteins relative expressions were pairwise positively associated with serum sTREM-1,TNF-αand IL-1βlevels(all P<0.001).ROC showed that AUC of serum sTREM-1,TNF-αand IL-1βlevels for diagnosing PPROM were 0.916,0.785 and 0.815,respectively(all P<0.05);the AUC of serum sTREM-1 for diagnosing CA was 0.935(P<0.05).Conclusion Elevated serum sTREM-1 level in PPROM patients
作者
袁里朝
汤旭妮
范徐妃
徐浩
YUAN Lichao;TANG Xuni;FAN Xufei;XU Hao(Department of Obstetrics,Jinhua Municipal Central Hospital,Jinhua 321000,China;不详)
出处
《浙江医学》
CAS
2024年第9期938-942,949,共6页
Zhejiang Medical Journal
基金
浙江省基础公益研究计划项目(LQ19H040002)
金华市科技计划项目(2022C222549)。
关键词
未足月胎膜早破
可溶性髓系细胞触发受体-1
TNF-Α
IL-1Β
绒毛膜羊膜炎
Preterm premature rupture of membranes
Soluble triggering receptor expressed on myeloid cell-1
Tumor necrosis factorα
Interleukin 1β
Chorioamnionitis
