羊水中微核糖核酸-182表达与早产儿宫内感染和脑损伤的关系

目的 分析羊水中微核糖核酸-182(miR-182)的表达与早产儿宫内感染和脑损伤的关系,为预测宫内感染后早产儿脑损伤的发生提供有效的预防方法。方法 选取2015年12月-2019年1月在江苏大学附属医院生产的125例胎龄小于34周单胎早产儿进行研究,在孕妇分娩时留取10 ml羊水,酶联免疫吸附实验(ELISA)检测羊水中肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素10(IL-10)、转化生长因子β(TGF-β)、白细胞介素8(IL-8)含量,实时定量PCR检测羊水中miR-182表达。胎盘行病理检查,判断是否存在绒毛膜羊膜炎,早产儿进行头颅影像学检查以诊断脑损伤。基于临床绒毛膜羊膜炎,将所有病例分为宫内感染组和无宫内感染组。结果 宫内感染组60例,其中发生脑损伤20例(33%);无宫内感染组65例,其中发生脑损伤10例(15%)。宫内感染组羊水中除IL-10降低外,IL-1β、TNF-α、TGF-β、IL-8及miR-182表达量均较无宫内感染组明显升高(t=8.04、17.23、17.37、15.56、4.90、18.13,P<0.001)。宫内感染组中合并脑损伤和无宫内感染组中合并脑损伤的羊水中miR-182表达量均较无脑损伤的明显上升(t=14.41、16.39,P＜0.05)。结论 羊水中miR-182的表达与羊水中炎症细胞因子有协同作用,初步推测对早产儿宫内感染和脑损伤有促进作用,可联合细胞因子预测宫内感染后早产儿脑损伤。

Association of the expression of miR-182 in amniotic fluid with intrauterine infection and brain injury in premature infants

Objective To study the association of the expression of micro-ribonucleic acid-182(miR-182) in amniotic fluid with intrauterine infection and brain injury in premature infants,in order to provide reference for predicting the occurrence of brain injury in preterm infants after intrauterine infection. Methods Totally 125 singleton infants with gestational age less than 34 weeks were included in this study in Affiliated Hospital of Jiangsu University from December 2015 to January 2019.10 ml amniotic fluid was collected by pregnant women at birth for pathological diagnosis.The contents of TNF-α,IL-1β,IL-10,TGF-β and IL-8 in amniotic fluid were detected by enzyme-linked immunosorbent assay.The expression of miR-182 in amniotic fluid was detected by real-time quantitative PCR.Placenta was examined by pathology to determine the presence of chorioamnionitis.All premature infants conducted brain imaging to detect brain damage at the right timing.All cases were divided into intrauterine infection group and non-intrauterine infection group according to clinical chorioamnionitis result. Results There were 60 cases in intrauterine infection group,including 20 cases (33%) with brain injury.And 65 cases were in non-intrauterine infection group,including 10 cases (15%) with brain injury.The levels of IL-1β,TNF-α,TGF-β,IL-8 and miR-182 in intrauterine infection group were significantly higher than that in non-intrauterine infection group except from IL-10 (t=8.04,17.23,17.37,15.56,4.90,18.13,P<0.001).The expression of miR-182 in amniotic fluid was significantly higher in intrauterine infection group combined with brain injury than that without brain infection,which was also higher in non-intrauterine infection group combined with brain injury(t=14.41,16.39,P＜0.05). Conclusion s The expression of miR-182 in amniotic fluid has synergistic effect with inflammatory cytokines in amniotic fluid.It is presumed that miR-182 in amniotic fluid can promote intrauterine infection and brain injury in premature infants,and can also predict brain damage in preterm infants after intrauterine infection when combined with cytokines.