以羊水中粒细胞集落刺激因子预测绒毛膜羊膜炎的价值

The value of forecasting chorioamnionitis with the content of Granulocyte colony-stimulating factor in amniotic fluid

目的:通过检测分娩时羊水中GCSF和IL6的含量及其与病理诊断为绒毛膜羊膜炎(CAM)的关系,研究测定羊水中GCSF和IL6的含量用以预测CAM的价值。方法:将研究对象按是否胎膜早破分为两组,均排除产科并发症及内外科合并症。两组产妇于分娩时抽取羊水5ml,用ELISA法检测羊水中GCSF和IL6的含量,同时两组产妇均于产后留取胎膜,用HE染色法检测是否存在CAM。结果:胎膜早破(PROM)组与对照组在年龄、孕周间差异无显著性的条件下,PROM组羊水中GCSF和IL6的含量高于对照组,差异有显著性,并且随着破膜时间延长而增高,各组间差异有显著性;CAM组羊水中GCSF和IL6的含量高于非CAM组,并且随着病理级别的增加,羊水中GCSF和IL6的的含量增加,其水平高低和胎盘炎症的组织学分级有明显的线性关系,组间差异有显著性;GCSF与IL6相比有较高的敏感性和特异性。结论:羊水中GCSF、IL6可作为CAM的早期诊断指标,且GCSF优于IL6。羊水中GCSF、IL6可作为反映绒毛膜羊膜炎严重程度的指标。

Objective：To study the value of forecasting CAM with the content of G-CSF and IL-6 in amniotic fluid, by discussing the relation between the content of G-CSF and IL-6 in amniotic and the pathology validated CAM before childbirth. Methods：The subjects were divided into two groups according to whether PROM or not,both eliminating the obstetrical complication and medical and surgery complication. The two groups of lying in women are abstracted 5ml of amniotic fluid,To detect the content of G-CSF and IL-6 in amniotic fluid by ELISA,meanwhile maintain the fetal membranes of the two groups of lying-in women after childbirth and to detect whether there is CAM by the HE staining. Results：The age and gestational weeks between the two groups of lying-in women in this research have no notable difference. The content of G-CSF and IL-6 in amniotic fluid between PROM group and the contrast group have obvious difference which will be rising along with the time of membrane rupture increasing. difference among three groups are obvious. The content of G-CSF and IL-6 in CAM group and non-CAM group have obvious difference which will be rising along with the degree of membrane rupture increasing the pathology validated CAM.difference among three groups are obvious, comparing with IL-6 ,G-CSF has higher sensitivity and specificity. Conclusions： Amniotic fluid G-CSF,IL-6 levels are valuable clinical indexes in identification of chorioamnionitis in patients with PROM. And G CSF is better marker for diagnosing chorioamnionitis than IL-6, G-CSF, IL-6 determination in amniotic fluid are sensitive indicator of degree of chorioamnionitis.