母血、羊水、脐血中细胞因子含量变化与胎膜早破、宫内感染及新生儿预后的关系

目的:探讨母血、羊水、脐血中3种细胞因子白细胞介素-6、8(interleukin-6、8,IL-6、8)、血管细胞粘附分子-1(vascular cell adhesion molecule,VCAM-1)对胎膜早破、绒毛膜羊膜炎和判断新生儿预后的临床意义。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,其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,差异具有显著意义(P<0.05,P<0.01),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>7分的新生儿(P<0.05,P<0.01)。结论:IL-6、IL-8、VCAM-13种细胞因子联合检测可用于胎膜早破并绒毛膜羊膜炎早期诊断,对判断新生儿预后也具有一定的临床价值。

The relationship between cytokine levels in maternal serum,amniotic fluid,umbilical cord serum and premature rupture of membranes,intrauterine infection and prognosis of neonates

Objective:To explore the relationship between cytokines levels of IL-6,IL-8 and vascular cell adhesion molecule-1(VCAM-1) in maternal serum,amniotic fluid and umbilical cord plasma of women with premature rupture of membranes,chorioamnionitis and predict prognosis of neonates.Methods:The levels of IL-6,IL-8 and VCAM-1 in maternal serum,amniotic fluid,umbilical cord serum were detected by enzyme linked immunosorbent assay in 58 pregnant women with premature rupture of membranes and 38 women with normal pregnancy(control group).Results:The levels of IL-6,IL-8 and VCAM-1 in premature rupture of membranes group were significantly higher than those in control group(P<0.05,P<0.01).The longer the duration from rupture of membrance to delivery was,the more serious chorioamnionitis was,and the higher the levels of IL-6,IL-8 and VCAM-1 were.The levels of IL-6,IL-8 and VCAM-1 in women with chorioamnionitis were significantly higher than those without chorioamnionitis(P<0.05,P<0.01).The levels of IL-6,IL-8 and VCAM-1 were significantly higher in neonates whose Apgar score≤7 than those in neonates whose Apgar score≥8.Conclusion:Measurement of IL-6,IL-8 and VCAM-1 levels in maternal serum,amniotic fluid,umbilical cord serum is an useful biomarker for identifying chorioamnionitis and predicting premature rupture of membranes.