母血、脐血、新生儿外周血中sCD14，MMP-8和sTREM-1表达水平与孕妇胎膜早破及新生儿围产期感染的相关性

Correlation between expression levels of sCD14,MMP-8,and sTREM-1 in maternal serum,umbilical cord serum,and neonatal peripheral serum and premature rupture of fetal membrane,neonatal infection during perinatal period

目的探讨母血、脐血、新生儿外周血中可溶性白细胞分化抗原14(sCD14),基质金属蛋白8(MMP-8)和可溶性髓样细胞表达触发因子受体1(sTREM-1)的表达水平在胎膜早破(prematureruptureoffetalmembranes,PROM)、绒毛膜羊膜炎和新生儿结局中的临床意义。方法采用双抗体夹心酶联免疫吸附法(ELISA)检测60例胎膜早破孕妇(PROM组)及60名正常孕妇(对照组)母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1表达水平;胎膜早破诊断标准参照第八版《妇产科学》、新生儿感染(新生儿肺炎、新生儿坏死性小肠结肠炎及新生儿败血症)诊断标准参照第四版《实用新生儿学》,行胎膜病理学检查诊断绒毛膜羊膜炎。结果PROM组母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1的水平均高于对照组(P<0.05),且表达水平随破膜时间的延长而升高;绒毛膜羊膜炎组患者母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1表达水平显著高于非绒毛膜羊膜炎组患者,两组比较差异有统计学意义(P<0.05);新生儿围产期感染组的母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1表达水平显著高于围产期无感染组(P<0.05)。结论sCD14,MMP-8和sTREM-1在母血、脐血、新生儿外周血中表达水平的变化及联合检测,对PROM、绒毛膜羊膜炎及新生儿围产期感染均具有一定的临床诊断意义。

Objective To explore the effects of expression levels of soluble CDI4 （sCD14）, matrix metalloproteinase-8 （ MMP-8）, and soluble triggering receptor expressed on myeloid cells- 1 （ sTREM- I ） in maternal serum, umbilical cord serum, and neonatal peripheral serum l premature rupture of fetal membrane （ PROM ） , chorioamnionitis, and neonatal prognosis. Methods Double antibody sandwich ELISA was used to detect the expression levels of sCD14, MMP-8, and sTREM-1 in maternal serum, mnbilical cord serum, and neonatal peripheral serum of 60 pregnant women with PROM （ PROM group） and 60 normal pregnant women （ control group） . The diagnostic criteria of PROM was based on the eighth edition of Obstetrics and Gynecology, the diagnostic criteria of neonatal infection （neonatal pneumonia, neonatal necrotizing enterocolitis, and neonatal sepsis） was based on the fourth edition of Practical Neonatology, the diagnostic criteria of chorioamnionitis was based on pathological examination of fetal membranes. Results The expression levels of sCD14, MMP-8, and sTREM- 1 in maternal serum, umbilical cord serum, and neonatal peripheral serum of PROM group were statistically significantly higher than those of control group （ P〉0. 05 ）, and the expression levels increased with the duration time of rupture of membrane. The expression levels of sCD14, MMP-8, and sTREM-1 in maternal serum, umbilical cord serum, and neonatal peripheral serum of patients with chorioamnioniris were statistically significantly higher than those of patients without chorioamnionitis （ P〈0. 05 ） . The expression levels of sCD14, MMP- 8, and sTREM- 1 in maternal serum, umbilical cord serum, and neonatal peripheral serum of patients with neonatal infection during perinatal period were statistically significantly higher than those of patients without neonatal infection during perinatal period （ P〈0. 05 ） . Conclu- sion The changes of expression levels of sCD14, MMP-8, and sTREM-1 in materual serum, umbilical cord serum, and neonatal peripher- al serum and joint detection have certain clinical significance for diagnosis of PROM, chorioamnionitis, and neonatal infection during perina- tal period.