贵州医科大学学报

2020, v.45;No.237(06) 727-732

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未足月胎膜早破新生儿脐血MCP-1和pro-ADM水平与绒毛膜羊膜炎的相关性
Analysis on the Correlation between MCP-1,pro-ADM Levels of Cord Blood and Chorioamnionitis in Neonates with Preterm Premature Rupture of Membranes

李惠;李秋红;赵越;
LI Hui;LI Qiuhong;ZHAO Yue;Department of Obstetrics,Qinhuangdao Maternal and Child Health Hospital;

摘要(Abstract):

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 1 min 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-1 and pro-ADM in cord blood of PPROM neonates with CAM are higher than those of the neonates without CAM,and the levels are positively correlated with the stage of CAM. Such two indexes can be used as auxiliary indicators for CAM diagnosis and disease evaluation.

关键词(KeyWords): 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)

Abstract:

Keywords:

基金项目(Foundation): 秦皇岛市科学技术局基金项目(201703A123)

作者(Author): 李惠;李秋红;赵越;
LI Hui;LI Qiuhong;ZHAO Yue;Department of Obstetrics,Qinhuangdao Maternal and Child Health Hospital;

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DOI: 10.19367/j.cnki.2096-8388.2020.06.020

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