胎膜早破孕产妇胎膜组织中NAMPT表达及其与绒毛膜羊膜炎的相关性

Relationship between expression of NAMPT in fetal membrane tissues of pregnant women with premature rupture of membranes and chorioamnionitis

目的 探讨胎膜早破(PROM)孕产妇胎膜组织中烟酰胺磷酸核糖转移酶(NAMPT)通路相关蛋白影响绒毛膜羊膜炎(CA)感染的机制。方法 选择天津市第三中心医院产科2018年6月-2021年6月分娩的PROM孕产妇为研究对象,其中62例合并CA为CA组,未合并CA产妇62例为非CA组。实时荧光定量聚合酶链式反应(RT-PCR)检测胎膜组织中NAMPT、基质金属蛋白酶(MMP)-1、MMP-3和MMP-8基因相对表达水平。酶联免疫吸附法(ELISA)检测血清白细胞介素(IL)-6和IL-10水平。结果 CA组产妇胎膜组织NAMPT、MMP-1、MMP-3和MMP-8 mRNA及血清IL-6、IL-10水平均高于非CA组(P<0.05);晚期CA组高于早期CA组和中期CA组(P<0.05),中期CA组高于早期CA组(P<0.05);受试者工作特征曲线(ROC)分析结果显示,胎膜组织NAMPT、MMP-1、MMP-3和MMP-8及血清IL-6、IL-10诊断PROM合并CA的曲线下面积分别为0.703、0.755、0.735、0.762、0.758、0.744。结论 NAMPT参与了PROM合并CA的发生、发展过程,其机制可能与影响胎膜组织细胞外基质成分改变以及炎症反应有关。

OBJECTIVE To explore the relationship between expression of nicotinamide phosphoribosyltransferase(NAMPT) pathway related proteins in fetal membrane tissues of pregnant women with premature rupture of membrane(PROM) and chorioamnionitis(CA). METHODS The pregnant women with PROM who gave birth in department of obstetrics and gynecology of Tianjin Third Central Hospital from Jun. 2018 to Jun. 2021 were recruited as the study objects, 62 of whom were complicated with CA and assigned as the CA group, 62 were not complicated with CA and assigned as the non-CA group. The relative expression levels of NAMPT, matrix metalloproteinase(MMP)-1, MMP-3 and MMP-8 genes in fetal membrane tissues were detected by means of real-time fluorescent quantitative polymerase chain reaction(RT-PCR). The levels of serum interleukin(IL)-6 and IL-10 were detected by using enzyme-linked immunosorbent assay(ELISA). RESULTS The levels of fetal membrane tissue NAMPT, MMP-1, MMP-3, MMP-8 mRNA and serum IL-6, IL-10 of the CA group were significantly higher than those of the non-CA group(P<0.05);the levels of above indexes of the advanced CA group were significantly higher than those of the early CA group and the mid-CA group(P<0.05);the levels of above indexes of the mid-CA group were significantly higher than those of the early CA group(P<0.05). Receiver operating characteristics(ROC) curve analysis showed that the areas under curves(AUCs) of the fetal membrane tissue NAMPT, MMP-1, MMP-3, MMP-8, serum IL-6 and IL-10 were respectively 0.703, 0.755, 0.735, 0.762, 0.758 and 0.744 in diagnosis of CA in the pregnant women with PROM. CONCLUSION NAMPTT participates in the occurrence and development of CA in the pregnant women with PROM, and the mechanisms may be related to the changes of the extracellular matrix components of the fetal membrane tissues and the inflammatory response.