孕妇血清、羊水可溶性人白细胞抗原-G与胎膜早破的相关性

sHLA-G expression levels in maternal serum and amniotic fluid and its correlations with premature rupture of membranes

目的 探讨sHLA-G在胎膜早破发生、发展过程中的作用以及相关性,并探讨其与组织学绒毛膜羊膜炎（histological chorioamnionitis,HCA）的相关性.方法 通过检测胎膜早破（promature rupture of memberes,PROM）及正常妊娠的孕妇血清及羊水中可溶性人白细胞抗原-G （soluble human leukocyte antigen-G,sHLA-G）的水平变化,采用酶联免疫吸附实验测定正常分娩的足月胎膜早破孕妇（term premature rupture of membrances,TPROM）、未足月胎膜早破孕妇（preterm pr-emature rupture of membranes,PPROM）各30例与正常妊娠对照组24例血清及羊水中sHLA-G的表达水平变化,以及观察其在HCA与非HCA组中两因子的水平变化.结果 （1）胎膜早破孕妇血清及羊水中sHLA-G水平与正常对照组相比均升高,并于产后胎膜组织病理检测出HCA组血清及羊水中sHLA-G的水平均高于非HCA组,差异均有统计学意义（P＜0.05）;（2）从破膜时间与胎膜HCA发生率的关系可知：＜8 h发生率为7.14％,8～12 h发生率为33.3％,＞12 h发生率为64.2％,3组比较,差异有统计学意义（P＜0.05）,可认为破膜时间越长感染发生率越高.结论 孕妇血清及羊水中sHLA-G水平升高可能参与了胎膜早破或合并有绒毛膜羊膜炎的发生,进而推测其可能作为胎膜早破或绒毛膜羊膜炎的临床诊断指标之一.

Objective To study the roles of soluble human leukocyte antigen-G（sHLA-G）in the occurrence and development of premature rupture of membranes and their correlations by detecting premature rupture of memberes（ PROM ）and the levels of sHI.A- G in maternal serum and amniotic fluid under normal pregnancy, and to evaluate the correlations of sHLA-G and IL-18 in predicting histological chorioamnionitis. Methods The levels of sHLA-G in materual serum and amniiotic fluid under normal pregnancy were detected, which among 30 cases of pregnant women in the term premature rupture of membrances （TPROM） group, 30 cases in the preterm premature rupture of membranes （PPROM） group and 24 cases in the control group by enzyme linked immunosorhent assay. And its correlation with histological chorioamnionitis was discussed. The data were analyzed by using statistical software of SPSS13.0. Resuits （ 1 ） The levels of sHLA-G in maternal serum and amniotic fluid of PROM group were both higher than those in normal control group. The postpartum fetal membrane pathological examination in PROM group showed that the levels of sHLA-G in chorioanmionitis patients were higher than those in non-chorioamnionitis patients, and the differences were statistically significant （P 〈 0.05 ）. （2）For the relationship between the fetal membranes rupture time and the incidence of fetal membrane chorioamnionitis ： the 〈 8 h incidence rate was 7.14% ,the 8-12 h incidence rate was 33.3% , the 〉 12 h incidence rate was 64.2% ; by comparing the incidences in three groups, the differences were statistically significant（ P 〈 0.05 ）. It was considered that the incidence of infection increased with increasing rupture time. Conclusion The increase in the levels of sHLA-G in maternal serum andamniotic fluid might be involved in the incidence of premature rupture of membranes,or with chorioamnionitis, sHLA-G is speculated to be as one of the clinical diagnostic indexes of premature rupture of membranes and amniotic infection.