胎膜早破绒毛膜羊膜炎患者细胞因子及基质金属蛋白酶水平变化及临床意义

摘要

目的:探讨胎膜早破绒毛膜羊膜炎患者细胞因子及基质金属蛋白酶水平变化及临床意义.方法:选取我院80例胎膜早破(premature rupture of membranes,PROM)孕妇,作为PROM 组,以80例正常孕妇作为对照组,其中PROM 组又根据有无发生绒毛膜羊膜炎(HCA)进行亚分组:HCA组45例和无HCA组35例.比较各组孕妇体内细胞因子(IL-8、IL-10、TNF-α)及基质金属蛋白酶(MMP-8、MMP-9)水平变化.结果:PROM 组IL-8、TNF-α水平显著高于对照组,差异有统计学意义(P<0.05);PROM 组IL-10水平显著低于对照组,差异有统计学意义(P<0.05).PROM 组合并 HCA孕妇体内IL-8、TNF-α水平显著高于非 HCA 组,IL-10水平著低于非 HCA 组,差异有统计学意义(P<0.05).PROM 组MMP-8、MMP-9水平显著高于对照组,差异有统计学意义(P<0.05).PROM 组合并 HCA孕妇体内MMP-8、MMP-9水平显著高于非 HCA组,差异有统计学意义(P<0.05).结论:胎膜早破及绒毛膜羊膜炎发生时,孕妇体内多伴有细胞因子及基质金属蛋白酶水平的变化,因此及时对上述指标进行监测,可为胎膜早破及绒毛膜羊膜炎者的早期诊断提供依据,有助于降低围产期孕妇及新生儿的发病率及死亡率,具有重要的临床价值.%Objective:To investigate changes of cytokines and matrix metalloproteinases in patients with premature rup-ture of membranes(PROM)with chorioamnionitis(HCA)and its clinical significance.Methods:80 pregnant women with pre-mature rupture of membranes were selected as PROM group and 80 normal pregnant women as control group.The PROM group was subgrouped into HCA group(n=45)and non HCA group(n=35)according to the presence or absence of HCA. Matrix metalloproteinases(MMP-8,MMP-9)and cytokines(IL-8,IL-10,TNF-α)in pregnant women were compared.Re-sults:The level of IL-8,TNF-αwere(420.45 ± 110.26)ng/L,(413.53 ± 125.19)ng/L in the PROM group,which were signifi-cantly higher than those in the control group;the levels of IL-10 were(332.07 ± 48.12)ng/L in the PROM groups,which were significantly lower than the control group(P<0.05).The levels of IL-8 and TNF-α in PROM combined with HCA group were significantly higher than those in non-HCA group,the levels of IL-10 were significantly lower than those in non-HCA group. The level of MMP-8,MMP-9 were(11.02 ± 2.48)ng/mL,(648.42 ± 73.35)ng/L in the PROM group,which were significantly higher than the control group(P<0.05).The levels of MMP-8,MMP-9 in PROM combined with HCA were significantly higher than those in non-HCA group with the difference was statistically significant(P<0.05).Conclusion:When premature rupture of membranes and chorioamniositis occurring,pregnant women were accompanied by the level changes of cytokines and matrix metalloproteinases,so timely monitoring of these indicators can offer basis for the early diagnosis the premature rupture of membranes and chorioamnionitis,which will help to reduce morbidity and mortality of the perinatal pregnant women and newborns with important clinical value.