CRP和MMP-9在预测未足月胎膜早破亚临床绒毛膜羊膜炎中的研究

The research of C-reactive protein and matrix metalloproteinase-9 on predication about subclinical chorioamnionitis in preterm premature rupture of the membranes

目的探讨C-反应蛋白(C-reactive protein,CRP)及基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)在预测未足月胎膜早破(preterm premature rupture of the membranes,PPROM)导致的亚临床绒毛膜羊膜炎中的作用。方法选择PPROM孕妇64例作为研究组,动态监测血清CRP及MMP-9的水平,产后根据病理检验结果,分为早产亚临床绒毛膜羊膜炎组(Ⅰ组)41例和早产非感染组(Ⅱ组)23例。同时选择相同孕周的未足月正常孕妇60例作为对照组。结果研究组Ⅰ组在破膜48、96 h及临产时CRP及MMP-9水平均高于研究Ⅱ组,差异均有统计学意义(P<0.05和P<0.01);研究组CRP及MMP-9水平均高于对照组,差异均有统计学意义(P<0.01)。孕妇血清MMP-9的临界点为382.45 ng/L,孕妇血清CRP的临界点为4.12 mg/L,为最适预测有无亚临床绒毛膜羊膜炎的值。结论动态联合监测PPROM的孕妇血清CRP及MMP-9的变化,有望成为早期预测亚临床绒毛膜羊膜炎的特异指标。

Objective To study the effects of C-reactive protein（CRP） and matrix metalloproteinase-9（MMP-9） on predication about subclinical chorioamnionitis in preterm premature rupture of the membranes（PPROM）.Methods 64 pregnant women of PPROM were selected to be continuously measured the levels of CRP and MMP-9 in serum,which were divided into two groups postpartum.The group I was 41 preterm combined subclinical chorioamnionitis,The group Ⅱwas preterm combined noninfection.Mean-while,60 normal pregnant women of incomplete pregnancy were selected as control group.Results The CRP levels and the MMP-9 levels of PPROMⅠgroup and Ⅱ group were significantly different after PROM 48 h,96 h and near the time of labour（P〈0.05 and P〈0.01）.The MMP-9 levels of PPROM group and control groups had significantly difference（P〈0.01）.382.45 ng/L was selected as MMP-9 criticalpoint,4.12 mg/L as CRP criticalpoint,they were the right number in predicting subclinical chorioamnionitis.Conclusion It is prospect in measuring the CRP and MMP-9 levels in serum of PPROM pregnant women continuously and will become specific target in predicting subclinical chorioamnionitis early.