白细胞介素8与早产的关系

目的　通过测定宫颈粘液中白细胞介素８（ＩＬ－８）的浓度及中性粒细胞数,探讨早产与感染的关系。　方法　用酶联免疫吸附（ＥＬＩＳＡ）法,对８２例先兆早产孕妇（研究组）和１０４例正常孕妇（对照组）宫颈粘液中ＩＬ－８进行检测,ＩＬ－８≥４５０ μｇ／Ｌ为阳性;在４００倍显微镜下对４９例先兆早产孕妇及１０４例正常孕妇宫颈粘液中中性粒细胞数进行检测。　结果　研究组孕妇宫颈粘液中,ＩＬ－８阳性率及中性粒细胞数明显高于对照组。　结论　通过此研究提示早产与生殖道感染有一定的关系,测定宫颈粘液中ＩＬ－８的含量可望成为预知早产及早产管理的一个有效方法     

白细胞介素-8和白细胞介素-6对分娩发动的影响

目的 探讨白细胞介素－８（ＩＬ－８）、白细胞介素－６（ＩＬ－６）在分娩发动中的作用。方法 随机选择孕３８￣４１的５４例胎膜完整的单胎初产妇临产前后共６０份血清样本,进行ＩＬ－８、ＩＬ－６水平测定并分进行对比分析。结果 妊娠晚期,随着孕周的增加,血清ＩＬ－８水平逐渐增高,逐渐变软展平。ＩＬ－８水平与宫颈Ｂｉｓｈｏｐ评分呈直线正相关。临瓣一血清ＩＬ０－８水平明显低于临产水平,且在第一产程各阶段差异显著     

早产孕妇绒毛膜促性腺激素及白细胞介素6水平的变化

早产是引起围产儿发病率和死亡率升高的首要因素。近年来 ,随着分子生物学和免疫学技术的飞速发展 ,人们对早产的病因、发病机制、诊断和预测指标等的研究逐渐深入[1] 。人绒毛膜促性腺激素 (ｈＣＧ)作为胎盘滋养细胞产生的一种糖蛋白激素 ,一直被用作早孕、异位妊娠、滋养细胞疾病等的诊断及疗效观察指标。最近有学者报道 ,妊娠中晚期β ｈＣＧ水平升高的孕妇 ,发生早产的机率显著增加[2 ] ;同时 ,炎性细胞因子———白细胞介素 6(ＩＬ 6)等在早产中的作用也日益受到重视[3] 。本研究通过检测早产孕妇血清 β ｈＣＧ、ＩＬ 6水平 ,并对胎盘…     

早产领域中白细胞介素10的研究进展

早产作为妊娠常见并发症之一,对孕妇及胎儿危害极大。近年研究发现,白细胞介素10(interleukin,IL-10)是一种重要的细胞因子,处在免疫调节的中心环节,并且在维持妊娠中起重要作用,它作为强有力的抗炎因子抑制促炎症细胞因子分泌。国内外多项临床试验和动物实验已证实IL-10在预测和治疗早产中有一定的作用。对IL-10更加深入的研究将为防治早产提供新的依据。     

白细胞介素6在早产胎膜早破孕妇血清及胎膜组织中的表达

探讨白细胞介素６在早产胎膜早破孕妇血清中的水平及其在胎膜组织中的表达与早产胎膜早破的方法。方法采用酶联免疫吸附法和免疫组化方法,对３０例早产胎膜早破孕妇和２０例正常孕妇血清中ＩＬ－６水平及肥膜组织ＩＬ－６蛋白表达进行检测。结论ＩＬ－６与感染引起的早产有关。     

白细胞介素-6、8在胎膜早破孕妇羊水、血清中的含量及意义

白细胞介素６、８在胎膜早破孕妇羊水、血清中的含量及意义李昭荣吕海侠梁劲荃王康敏马玉琴胎膜早破为常见产科并发症，发病率高［１］，与感染关系密切［２］，互为因果。目前，对胎膜早破孕产妇并发羊膜腔感染进行早期预测，并给予及时治疗，已成为降低围产期发病率和...     

羊水中明胶酶、白细胞介素8与胎膜早破关系的研究

目的　探讨明胶酶、白细胞介素 8(interleukin 8,IL 8)与胎膜早破 (PrematureRuptureofMembrane,PROM)发生的关系。　方法　PROM者 30例为观察组 ,正常孕妇 30例为对照组。于剖宫产时抽取羊水 3ml备存。羊水消化生物素标记明胶 ,用ELISA法测定剩余明胶的含量 ,换算出酶的活性。参照文献进行明胶电泳 ,酶经电泳分离后 ,将该处的明胶消化 ,染色后形成不着色的透明带 ;IL 8含量的测定 :用双抗体夹心ELISA法。　结果　 ( 1)在未临产、潜伏期和活跃期 ,观察组和对照组羊水总明胶酶的活性分别为 :( 85± 10 ) μg/L·12h、( 91± 7) μg/L·12h、( 10 4± 2 3) μg/L·12h和( 4 9± 15 ) μg/L·12h、( 5 8± 15 ) μg/L·12h、( 10 2± 2 9) μg/L·12h ,两组中活跃期显著高于未临产 (P <0 .0 1)。 ( 2 )在未临产期和潜伏期 ,观察组羊水中总明胶酶的活性均显著高于对照组 (P <0 .0 5 )。 ( 3)羊水中较明确的明胶酶带有 4条 ,分子量分别为 92、83、72和 6 6kd。观察组在未临产时羊水中各明胶酶消化的明胶带较对照组宽。 ( 4 )在未临产、潜伏期和活跃期 ,观察组和对照组羊水IL 8的含量分别为 :( 0 .195± 0 .110 ) μg/L、( 0 .2 76± 0 .12 8) μg/L、( 0 .333± 0 .134) μg/L和 ( 0 .10 2± 0 .0 5 6 ) μg/     

促肾上腺皮质激素释放激素、皮质醇和硫酸脱氢表雄酮在早产发动中的作用

目的探讨促肾上腺皮质激素释放激素（CRH）、皮质醇、硫酸脱氢表雄酮（DHEA—S）在早产发动中的作用。方法用原位杂交法检测早产阴道分娩产妇26例（早产组）、足月临产阴道分娩产妇29例（足月临产组）、足月未临产剖宫产产妇25例（足月未临产组）胎盘、胎膜组织中CRH mRNA的分布与表达,用放射免疫法测定3组产妇分娩的新生儿脐静脉血CRH,脐动脉血DHEA-S及皮质醇的含量。结果（1）各组产妇胎盘、胎膜组织中均可见CRH mRNA表达。（2）CRH mRNA在胎盘组织中表达的阳性指数：早产组为5．5±1．4,足月临产组为5．4±1．5,均高于足月未临产组的2．7±1．5。差异均有统计学意义（P〈0．01）;CRHmRNA在胎膜组织中表达的阳性指数：早产组为5．4±1．7,足月临产组为5．4±1．4,足月未临产组为2．0±1．4,早产组、足月临产组与足月未临产组比较,差异也有统计学意义（P〈0．01）;CRH mRNA在胎盘及胎膜中表达的阳性指数早产组与足月临产组比较,差异无统计学意义（P〉0．05）;各组产妇CRH mRNA在胎盘与胎膜组织中的表达比较,差异均无统计学意义（P〉0．05）。（3）早产组和足月临产组新生儿脐静脉血CRH含量分别为（7．8±3．3）、（7．7±4．1）ng／L,脐动脉血DHEA-S含量分别为（514±295）、（483±207）μg／L,均高于足月未临产组的（4．8±2．4）ng／L、（360±80）μg／L,差异有统计学意义（P〈0．05）;而早产组与足月临产组比较,差异则无统计学意义（P〉0．05）。早产组脐静脉血CRH含量与胎盘、胎膜组织中CRH mRNA的表达均呈正相关关系（r=0．935、0．853,P〈0．01）,足月临产组脐静脉血CRH含量与胎盘、胎膜组织中CRH mRNA的表达也呈正相关关系（r=0．902、0．825,P〈0．01）。（4）早产组新生儿脐动脉血皮质醇含量为（246±117）μg／L,明显高于足月临产组的（172±72）μg／L和足月未临产组的（127±60）μg／L,差异均有统计学意义（P〈0．05,P〈0．01）。早产组新生儿脐静脉血CRH与脐动脉血皮质醇、DHEA-S含量均呈正相关关系（r=0．523、0．424,P〈0．05）,足月临产组新生儿脐静脉血CRH与脐动脉血皮质醇、DHEA—S含量也呈正相关关系（r=0．438、0．354,P〈0．05）。结论（1）CRH与分娩发动密切相关,胎盘、胎膜组织中CRH mRNA表达升高可能是早产发动的重要原因。（2）DHEA—S、皮质醇与分娩的发动密切相关。     

分娩期子宫下段肌层白细胞的分布及IL-8、IL-8mRNA的表达

目的:观察分娩期宫颈不同扩张程度下的子宫下段肌层组织中白细胞的分布及白细胞介素-8(IL-8)及IL8 mRNA的表达,探讨宫颈扩张机制。方法:(1)应用半定量逆转录-聚合酶链反应(RT-PCR)技术测定宫颈不同扩张程度下(A组宫颈口开大<4cm,B组宫颈口开大≥4cm,各20例)子宫下段肌层IL-8mRNA的表达;(2)用免疫组织化学SP法检测中性粒细胞、巨噬细胞和IL-8在宫颈不同扩张程度下子宫下段肌层组织上的表达。结果:随着宫颈的扩张,B组的中性粒细胞和巨噬细胞数均明显高于A组(P<0.01,P<0.01);B组的IL-8mRNA的相对表达量及IL-8的表达强度均显著高于A组(P<0.01,P<0.01)。结论:宫颈扩张过程类似急性炎症反应;IL-8参与宫颈扩张,是宫颈扩张过程中的重要环节。     

动脉导管未闭早产儿血清皮质醇水平变化及临床意义

目的 探讨血清皮质醇水平与早产儿动脉导管未闭(patent ductus arteriosus,PDA)的关系.方法 选择2009年1月1日至12月31日间出生后即在福建省妇幼保健院新生儿科治疗的432例早产儿为研究队列,预采集其桡动脉血,以出生3 d后诊断PDA的为PDA组,按照1∶1匹配巢式病例对照研究的方法,选择同期住院的胎龄相近(相差小于1周)、有相同的孕母产前地塞米松应用史,同一日龄行超声心动图排除PDA的早产儿为对照组进行匹配,共38对.收集两组早产儿临床资料,并在行超声心动图的当天第2次采集桡动脉血.用化学发光法检测两组两次血标本的血清皮质醇水平,并采用Logistic回归分析方法 分析PDA的危险因素.结果 PDA组及对照组的性别比例、胎龄、分娩方式、出生窒息史、是否合并呼吸衰竭、败血症以及血清球蛋白、白蛋白值的差异无统计学意义(P均＞0.05).PDA组出生时的血清皮质醇浓度为(261.9±229.6)nmol/L,低于对照组的(379.8±236.3)nmol/L,差异有统计学意义(t=2.20,P=0.03).条件 Logistic回归分析显示出生低血清皮质醇水平是早产儿发生PDA的危险因素(OR=0.916,95%CI:0.854～0.983,P=0.015).在控制了出生血清皮质醇基础值、缺氧、感染、危重症等影响因素后,PDA组和对照组的第2次血清皮质醇浓度的校正均值(95%CI)分别为300.0 nmol/L(232.4～367.4 nmol/L)和263.6 nmol/L(196.2～331.2 nmol/L),两组比较差异无统计学意义(t=0.537,P=0.466).结论 出生低血清皮质醇水平是早产儿PDA的危险因素,而早产儿发生PDA不影响血清皮质醇水平.

Abstract：

Objective To determine the relationship between the levels of serum cortisol and patent conducted.Thirty-eight pairs of preterm infants were selected from January 1 to December 31 in 2009.Thirty-eight preterm infants developed PDA.And we also selected 38 non-PDA preterm infants as the controls,who had the corresponding gestational age,same exposure to antenatal steroid and sameechocardiography examination time.The serum cortisol concentrations of these infants were measured twice by chemiluminesence immunoassay.All data were analyzed via SPSS 13.0.Results No significant difference was found between PDA and control groups in demographic characteristics and influence factors for serum cortisol.The first mean level of serum cortisol in PDA group was (261.9± 229.6) nmol/L,significantly lower than that in control group [(379.8 ± 236.3) nmol/L] (t = 2.20,P = 0.03).Logisticregression analysis showed low serum cortisol concentrations at birth was risk factor for PDA in preterm infants(OR = 0.916,95% CI:0.854-0.983,P = 0.015).The second adjusted mean levels (95 % CI) of serum cortisol in PDA and control groups were 300.0 nmol/L(232.4-367.4 nmol/L) and 263.6 nmol/L (196.2-331.2 nmol/L),respectively.There was no significant difference between the two groups (t=0.537,P=0.466).Conclusions Low serum cortisol concentrations at birth is a risk factor for PDA in preterm infants,while the serum cortisol value may be not affected by PDA.     

Nursing's contribution to the literature on preterm labor and birth

Although preterm labor and birth continues to plague us as an unsolved mystery in maternal/child health, much has actually been learned over the past few decades. Most reviews of the preterm labor literature examine the research in an interdisciplinary manner; this article instead looks at the active role that nurses have taken in the research concerning preterm labor and birth. This article will categorize research conducted by nurses over the past 30 years on preterm labor and birth, emphasizing some of the changes in nursing practice engendered by nursing's important research effort.     

脐血清皮质醇和硫化脱氢表雄酮在足月分娩时的作用

目的　探讨脐血清皮质醇和硫化脱氢表雄酮在足月分娩时的作用。方法　采用放射免疫法测定 10 0例足月分娩新生儿脐血清中皮质醇和硫化脱氢表雄酮的含量 ,其中A组 18例 ,为无阵痛、选择性剖宫产产妇 ;B组 10例 ,为潜伏期剖宫产产妇 ;C组 12例 ,为活跃期剖宫产产妇 ;D组 60例 ,为阴道分娩产妇。结果　 (1)新生儿脐血清皮质醇含量随孕周增加而增加 ,至 3 9周时脐血清皮质醇含量达峰值 ,为 (2 86± 5 0 ) μg/L ,42周时 ,皮质醇含量下降 ,接近孕 3 7周水平 (194± 70 ) μg/L ,血清硫化脱氢表雄酮含量变化与之相平行 ,两者呈正相关 [相关系数 (r) =0 .46,P <0 .0 5 ]。 (2 )A、B、C组随着产程进展 ,皮质醇含量增加 ,硫化脱氢表雄酮含量不增加。 (3 )D组新生儿脐血清皮质醇含量较其他 3组高 (P <0 .0 1)。硫化脱氢表雄酮含量变化无差异。结论　脐血清皮质醇和硫化脱氢表雄酮在分娩发动和加速中起着重要作用     

环氧合酶2及前列腺素15-羟基脱氢酶在早产患者胎盘及胎膜组织中的表达

目的探讨环氧合酶2(COX-2)、前列腺素15-羟基脱氢酶(15-PGDH)在胎盘和胎膜组织中的表达变化及其与早产发生的关系。方法采用免疫组化二步法,测定14例早产产妇(早产组)、18例足月临产产妇(足月临产组)、17例足月未临产产妇(对照组)的胎盘和胎膜组织中COX-2与15-PGDH的定位与表达水平(以阳性百分数计分和细胞染色计分相加表示)。结果(1)COX-2在3组产妇的羊膜上皮细胞、绒毛膜细胞和蜕膜细胞的胞质中均有表达。COX-2在早产组胎膜和胎盘组织羊膜上皮细胞中的表达水平分别为(4·6±1·2)、(4·7±0·9)分,在足月临产组分别为(3·2±1·0)、(3·6±1·0)分,在对照组分别为(2·2±0·6)、(2·5±0·9)分。早产组及足月临产组明显高于对照组,两两比较,差异均有统计学意义(P<0·01);早产组与足月临产组比较,差异也有统计学意义(P<0·01)。3组间胎膜羊膜上皮细胞与胎盘羊膜上皮细胞中的COX-2表达水平相互比较,差异均无统计学意义(P>0·05)。(2)COX-2在早产组胎盘绒毛膜细胞中的表达水平为(4·9±1·0)分,在足月临产组为(3·9±1·2)分,在对照组为(2·3±0·7)分,早产组及足月临产组明显高于对照组,两两比较,差异均有统计学意义(P<0·01);早产组与足月临产组比较,差异也有统计学意义(P<0·01)。而3组胎膜绒毛膜组织中COX-2表达水平比较,差异无统计学意义(P>0·05);在3组胎盘蜕膜细胞中的表达水平比较,差异也无统计学意义(P>0·05)。(3)15-PGDH在3组产妇羊膜上皮细胞、绒毛膜细胞和蜕膜细胞的胞质中均有表达,3组胎膜及胎盘组织的羊膜上皮细胞中15-PGDH表达水平比较,差异无统计学意义(P>0·05);而在胎膜及胎盘组织的绒毛膜细胞中表达水平,早产组分别为(1·5±0·6)、(2·3±0·8)分,足月临产组分别为(2·6±0·8)、(3·0±0·7)分,对照组分别为(4·4±1·1)、(4·1±1·2)分,早产组及足月临产组明显低于对照组,两者比较,差异有统计学意义(P<0·01);早产组与足月临产组比较,差异也有统计学意义(P<0·05)。在胎盘组织蜕膜细胞中的表达水平,早产组为(2·1±0·7)分,足月临产组为(2·8±0·8)分,对照组为(4·5±1·0)分,早产组及足月临产组明显低于对照组,两者比较,差异有统计学意义(P<0·01);早产组与足月临产组比较,差异也有统计学意义(P<0·05)。结论COX-2在羊膜上皮细胞中的高表达和15-PGDH在绒毛膜、蜕膜细胞中的低表达,与早产的分娩发动有关。二者在早产的发生中起一定作用。     

A randomized study of antibiotic therapy in idiopathic preterm labor

A randomized study was undertaken to test the effects of antibiotics as an adjunct to established methods of tocolysis. One hundred fifty patients with cervical dilation of 1 cm or more and no clinically identifiable cause for preterm labor qualified for the study. Fifty-three (35%) received 500 mg ampicillin orally every 6 hours, 50 (33%) received 500 mg erythromycin orally every 6 hours, and 47 served as controls. Antibiotics were prescribed for 10 days, and the treatment was not altered by the results of cervical cultures. Of these 150 patients, 16 (11%) had positive amniotic fluid cultures. The pregnancies with positive amniotic fluid culture were characterized by significantly less time gained after admission (2.6 versus 28.7 days) and lower birth weight (1262 versus 2470 g) than in those with negative cultures. Histologic studies of the placenta revealed chorioamnionitis in 22 (16%) of 134 patients with negative amniotic fluid cultures; these pregnancies were associated with less time gained after admission (12.5 versus 31.9 days) and lower birth weight (1680 versus 2618 g) compared with pregnancies without histologic chorioamnionitis. In patients with similar gestational age and cervical dilation, the adjunctive use of antibiotic therapy resulted in a statistically significant delay from admission to delivery (30 versus 17 days). In cases of negative amniotic fluid cultures, cervical colonization with group B streptococcus and/or Gardnerella vaginalis increased the risk of prematurity, which improved significantly when ampicillin was given.     

Maternal serum interleukin-6, interleukin-8, tumor necrosis factor-alpha and interferon-gamma in preterm labor

BACKGROUND: To find out whether preterm labor is associated with raised maternal serum concentrations of interleukin (IL)-6, IL-8, tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) and whether the measurement of these cytokines can be used to detect early intrauterine infection in preterm labor. METHODS: Cross-sectional study: 77 women in preterm labor, 47 controls of healthy preterm women not in labor and 19 women in term labor. The serum cytokines levels were measured by enzyme-linked immunosorbent assay (ELISA). The newborns of women who were in labor were followed up for evidence of infection. Differences between groups were tested using analysis of variance, Student's t-test and chi2-test. RESULTS: There was no significant difference in the concentration of all the cytokines measured between the different groups. No statistical difference was found in the concentration of the cytokines between women in preterm labor with ruptured membranes and those with intact membranes. There was also no difference found in the concentration of cytokines between women whose newborns had positive bacterial culture and those with negative culture. There was a positive correlation between the concentrations of IL-6, IL-8 and TNF-alpha. CONCLUSION: Serum levels of interleukin-6, interleukin-8 and tumor necrosis factor-alpha were not increased in preterm labor compared to normal control women. There is doubt regarding the usefulness of maternal serum measurement of these cytokines for the detection of early fetal infection in preterm labor, but this needs further evaluation.