PAF、G-CSF水平与未足月胎膜早破并发绒毛膜羊膜炎的相关性研究

Study on the correlation between levels of PAF,G-CSF and premature rupture of membranes and chorioamnionitis

目的探究血小板激活因子(PAF)、粒细胞集落刺激因子(G-CSF)与未足月胎膜早破并发绒毛膜羊膜炎的相关性。方法选取胎膜早破孕妇99例作为研究对象,其中未足月胎膜早破者49例作为未足月组,足月胎膜早破者50例作为足月组,另外选取同期正常妊娠孕妇49例作为对照组。测定3组羊水、血清及脐血中PAF和G-CSF水平,统计足月组与未足月组绒毛膜羊膜炎发生率,比较发生绒毛膜羊膜炎与未发生绒毛膜羊膜炎的胎膜早破孕妇血清、羊水及脐血中PAF和G-CSF水平差异,对胎膜早破孕妇的孕周与血清PAF和G-CSF水平进行相关性分析,采用ROC曲线分析血清G-CSF及PAF对胎膜早破孕妇并发绒毛膜羊膜炎、未足月孕妇并发绒毛膜羊膜炎、足月孕妇并发绒毛膜羊膜炎的诊断价值。结果3组血清、羊水及脐血中PAF和G-CSF水平比较差异均有统计学意义(P均<0.05),且未足月组高于足月组(P均<0.05),足月组高于对照组(P均<0.05)。未足月组的绒毛膜羊膜炎发生率显著高于足月组(P<0.05)。在胎膜早破孕妇人群中,发生绒毛膜羊膜炎者血清、羊水及脐血中PAF和G-CSF水平均显著高于未发生绒毛膜羊膜炎者(P均<0.05)。胎膜早破孕妇的孕周与血清PAF及G-CSF水平存在显著负相关性(P均<0.05)。未足月胎膜早破孕妇的血清G-CSF对绒毛膜羊膜炎的诊断灵敏度较高,而血清PAF对绒毛膜羊膜炎的诊断特异度较高。结论孕妇外周血清G-CSF、PAF水平可作为未足月胎膜早破并发绒毛膜羊膜炎的预测因子,能够为未足月胎膜早破实施期待治疗提供依据。

Objective It is to investigate the correlation of platelet activating factor （PAF）, granulocyte colony-stimulating factor （G-CSF） with premature rupture of membranes and eborioamnionitis. Methods Ninety-nine pregnant women with premature rupture of membranes （PROM） were enrolled in this study, in which 49 cases of preterm PROM as preterm group, and 50 cases of full-term PROM as full-term group. In addition, 49 normal pregnant women were selected as the control group. The levels of PAF and G-CSF in venous blood, umbilical vein blood, andamniotie fluid in each group were measured prenatally. The incidence rate of chorioamnionitis in preterm group and full-term group was counted, the differences in the levels of PAF and G-CSF in venous blood, umbilical vein blood, andamniotic fluid between chorioamnionitis group and non-chorioamnionitis group were compared. The correlation of pregnant week with serum levels of PAF and G-CSF were analyzed in PROM women. ROC curve was used to analyze the diagnosis value of serum G-CSF and PAF for PROM with chorioamnionitis. Results There were significant differences in PAF and G-CSF in amniotic fluid, serum and umbilical cord blood among the three groups（P 〈0.05）, and the levels of each index in preterm group were higher than those in fullterm group, the levels in full-term group were higher than those in control group （P 〈 0. 05）. The incidence of chorioamnionitis in term group was significantly higher than that in term group （ P 〈 0. 05）. In pregnant women with PROM, the levels of PAF and G-CSF in venous blood, umbilical vein blood, andamniotic fluid in ehorioamnionitis patients were significantly higher than those without chorio-amnionitis （ P 〈 0. 05 ）. Pregnant week had a significant negative correlation with serum PAF and serum G-CSF in pregnant women with PROM（P 〈0.05）. The sensitivity of serum G-CSF to amnionitis was higher, while the specificity of serum PAF to amnionitis was higher in pregnant women in preterm group. Conclusion The results of G-CSF and PAF in peripheral blood of pregnant women can be used as a predictor of premature rupture of membranes with chorioamnionitis, which can provide a basis for expectant treatment.