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胎膜早破并发宫内感染病原菌及Caspase-3和Bcl-2与AIF表达
引用本文:柳月霞,刘小丽,魏菊红,陈蕾,高湛.胎膜早破并发宫内感染病原菌及Caspase-3和Bcl-2与AIF表达[J].中华医院感染学杂志,2021(3):459-462.
作者姓名:柳月霞  刘小丽  魏菊红  陈蕾  高湛
作者单位:;1.郑州大学第五附属医院妇产科;2.南阳市第二人民医院产科
基金项目:河南省医学科技攻关计划项目(2018020238)。
摘    要:目的探讨胎膜早破(PROM)并发宫内感染病原特点及胱天蛋白酶-3(Caspase-3)、B淋巴细胞瘤/白血病-2基因(Bcl-2)、凋亡诱导因子(AIF)表达改变研究。方法选择南阳市第二人民医院2018年5月-2019年11月收治的PROM产妇108例作为研究组,根据是否足月分为足月PROM组61例和未足月PROM组47例,另根据其是否合并宫内感染分为感染患者42例和非感染患者66例,并选择同期未发生胎膜早破的正常妊娠产妇50例作为对照,纳入对照组。对合并宫内感染的PROM产妇病原菌进行调查。采用免疫组化法检测产妇胎膜组织中Caspase-3、Bcl-2、AIF表达水平,对足月/未足月、感染/非感染PROM及对照组产妇三指标表达水平进行比较。结果 42例合并宫内感染的PROM产妇羊水中共检出病原菌58株,其中细菌41株占70.69%,真菌17株占29.31%,以B族链球菌、大肠埃希菌和白假丝酵母为主。未足月PROM组Caspase-3、AIF分别为5.53±1.59、3.87±1.15高于足月PROM组及对照组、Bcl-2为4.31±2.07低于足月PROM组及对照组(P均<0.001);足月PROM组Caspase-3、AIF分别为3.01±1.22、1.97±0.64高于对照组、Bcl-2为6.72±2.96低于对照组(P均<0.001);感染患者Caspase-3、AIF为5.47±1.43、3.61±1.20高于非感染患者及对照组、Bcl-2为4.31±2.07低于非感染患者及对照组(P均<0.001);非感染组Caspase-3、AIF分别为3.32±1.28、1.82±0.62高于对照组、Bcl-2为6.37±2.60低于对照组(P均<0.001)。结论胎膜早破并发宫内感染病原菌以B族链球菌、大肠埃希菌和白假丝酵母为主,患者胎膜组织存在Caspase-3、AIF表达上调、Bcl-2表达下调,其免疫学机制及临床价值仍有待进一步研究。

关 键 词:胎膜早破  宫内感染  胱天蛋白酶-3  B淋巴细胞瘤/白血病-2基因  凋亡诱导因子

Pathogens of premature rupture of membranes complicated by intrauterine infection and changes of Caspase-3,Bcl-2,AIF
LIU Yue-xia,LIU Xiao-li,WEI Ju-hong,CHEN Lei,GAO Zhan.Pathogens of premature rupture of membranes complicated by intrauterine infection and changes of Caspase-3,Bcl-2,AIF[J].Chinese Journal of Nosocomiology,2021(3):459-462.
Authors:LIU Yue-xia  LIU Xiao-li  WEI Ju-hong  CHEN Lei  GAO Zhan
Institution:(The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China;不详)
Abstract:OBJECTIVE To investigate the pathogenic characteristics of premature rupture of membranes(PROM) complicated by intrauterine infections and the changes in the expression of caspase-3, B lymphoma/leukemia-2 gene(Bcl-2), and apoptosis inducing factor(AIF). METHODS Totally 108 cases of PROM parturients admitted to the Nanyang Second People′s Hospital from May 2018 to Nov. 2019 were selected as the research group, and were divided into 61 cases of term PROM group and 47 cases of preterm PROM group according to whether they were full term or not, and were in additionally divided into 42 cases of infected patients and 66 cases of non-infected patients according to whether combined with intrauterine infection, and 50 cases of normal pregnant women without premature rupture of membranes during the same period were selected as the control group. The pathogenic bacteria of PROM with intrauterine infection were investigated. Immunohistochemical method was used to detect the expression levels of Caspase-3, Bcl-2, and AIF in the fetal membrane tissues of the parturients, and the expression levels of three indicators were compared for term versus term, infected versus non-infected and PROM versus control group. RESULTS A total of 58 pathogens were detected in the amniotic fluid of 42 PROM maternal patients with intrauterine infection, of which 41 strains of bacteria accounted for 70.69%, and 17 strains of fungi accounted for 29.31%, mainly group B Streptococcus, Escherichia coli and Candida albicans. Caspase-3 and AIF of preterm PROM group were 5.53±1.59 and 3.87±1.15, respectively, higher than term PROM group and control group, Bcl-2 was 4.31±2.07, significantly lower than term PROM group and control group(P<0.001);Caspase-3 and AIF of term PROM group were 3.01±1.22 and 1.97±0.64, respectively, significantly higher than control group, Bcl-2 was 6.72±2.96, significantly lower than control group(P<0.001);Caspase-3 and AIF of infected patients were 5.47±1.43 and 3.61±1.20, respectively, significantly higher than those of non-infected patients and control group, Bcl-2 was 4.31±2.07, significantly lower than that of non-infected patients and control group(P<0.001);Caspase-3 and AIF of non-infected group were 3.32±1.28 and 1.82±0.62, respectively, significantly higher than those of the control group, and Bcl-2 was 6.37±2.60, significantly lower than that of the control group(all P<0.001). CONCLUSION The pathogens of premature rupture of fetal membranes and intrauterine infection were mainly group B streptococcus, E coli and C albicans. The expressions of Caspase-3, AIF were up-regulated and Bcl-2 was down-regulated in the patient′s fetal membrane tissue of patients. The immunological mechanism and clinical value of patients still need to be further studied.
Keywords:Premature rupture of membranes  Intrauterine infection  Caspase-3  B lymphoma/leukemia-2 gene  Apoptosis-inducing factor
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