胎膜早破时母血、羊水、脐血中细胞因子IL-6、IL-8、VCAM-1含量监测及其临床价值.docVIP

胎膜早破时母血、羊水、脐血中细胞因子IL-6、IL-8、VCAM-1含量监测及其临床价值 【关键词】 胎膜 【摘要】 目的 探讨母血、羊水、脐血中三种细胞因子白细胞介素-6、8(interleukin-6、8)、血管细胞黏附分子-1(vascular cell adhesion molecule, VCAM-1)对胎膜早破、绒毛膜羊膜炎和新生儿预后判断的临床意义。方法 采用双抗体夹心酶联免疫吸附法检测58例胎膜早破及38例正常妊娠孕妇(对照组) 母血、羊水、脐血中IL-6、IL-8、VCAM-1水平的动态变化，同时进行胎膜的病理检查。结果 胎膜早破组母血、羊水、脐血中IL-6、IL-8、VCAM-1的含量均高于对照组，母血、羊水、脐血中IL-6、IL-8、VCAM-1的含量随破膜时间的延长而增高，尤其破膜时间超过24h增高更为明显。绒毛膜羊膜炎患者母血、羊水、脐血中IL-6、IL-8、VCAM-1水平明显高于非绒毛膜羊膜炎患者，差异具有显著性（P0.05, P0.01），胎膜早破组产妇所生新生儿Apgar评分≤7分者，其母血、羊水、脐血中IL-6、IL-8、VCAM-1的含量显著高于Apgar≥8分的新生儿（P0.05,P0.01）。结论 IL-6、IL-8、VCAM-1三种细胞因子联合检测可用于胎膜早破并绒毛膜羊膜炎的早期诊断，对新生儿预后判断也具有一定的临床价值。 【关键词】 白细胞介素-6；白细胞介素-8；血管细胞黏附分子-1；胎膜早破；绒毛膜羊膜炎 Maternal serum, amniotic fluid,umbilical cord serum cytokine levels in pregnancies complicated by PROM LU Dan,WANG Zhi-xue,WANG Xiao-ling,et al. Department of Obstetrics and Gynecology, Yangzhou University College of Medicine, Yangzhou 225001,China 【Abstract】 Objective To evaluate the maternal serum, umbilical cord plasma and amniotic fluid cytokines levels(IL-6,IL-8 and VCAM-1) in pregnancies complicated by premature rupture of membranes (PROM).Methods The levels of IL-6,IL-8 and VCAM-1 were detected by enzyme linked immunosorbent assay in maternal serum,amniotic fluid,umbilical cord serum of 58 pregnant women with PROM and 38 women with normal pregnancies. Chorioamnionitis was histopathologically confirmed after delivery.Results The levels of IL-6,IL-8 and VCAM-1 were significantly higher in maternal serum,amniotic fluid,umbilical cord serum in patients with PROM group than those of the control group（P0.05,P0.01）.Thelongerthe duration from rupture of membrances to delivery was,the more serious chorioamnionitis was,and the higher the levels of IL-6,IL-8 and VCAM-1 in maternal serum,amniotic fluid,umbilical cord serumwere. The levels of IL-6,IL-8 and VCAM-1were significantly higher in maternal serum,amniotic fluid,umbilical cord serum in patients with chorioamnionitis than those of non-chorioamnionitis（P0.05,P0.01）. The levels of IL-6