血清淀粉样蛋白A与未足月胎膜早破并发亚临床绒毛膜羊膜炎的关系研究

Relationship between serum amyloid A and subclinical chorioamnionitis in preterm premature rupture of membrane

目的探讨母体血清淀粉样蛋白A与未足月胎膜早破并发亚临床绒毛膜羊膜炎的关系。方法 2016年2月至9月在南方医科大学南方医院选取足月胎膜早破组、未足月胎膜早破组、足月对照组和未足月对照组孕妇各30例,比较4组分娩前血清淀粉样蛋白A水平及胎盘胎膜病理结果。结果 (1)未足月胎膜早破组血清淀粉样蛋白A显著高于足月胎膜早破组和两组对照组(P<0.001)。(2)足月胎膜早破组和未足月胎膜早破组组织学绒毛膜羊膜炎阳性率显著高于对照组(P<0.05)。(3)组织学绒毛膜羊膜炎阳性者血清淀粉样蛋白A显著高于组织学绒毛膜羊膜炎阴性者(P<0.05)。(4)未足月胎膜早破合并组织学绒毛膜羊膜炎者血清淀粉样蛋白A界值为17.55mg/L时约登指数最高。结论血清淀粉样蛋白A与未足月胎膜早破和组织学绒毛膜羊膜炎密切相关。

Objective To investigate the relationship between serum amyloid A and subclinical chorioamnionitis in preterm premature rupture of membrane.Methods Thirty women of premature rupture of membrane, 30 women of preterm premature rupture of membrane, 30 women of term normal pregnancy （control group）and 30 women of preterul normal pregnancy in Nanfang Hospital, Southern Medical University between February and September 2016 were retrospectively analyzed for serum amyloid A level arid placenta pathology.Results （ 1 ） The value of serum amyloid A in preterm premature rupture of membrane group was significantly higher than that in premature rupture of membrane group and control group, P〈0.001. （2）The incidence of histological chorioamnionitis in premature rupture of membrane group and preterm premature rupture of membrane group were higher than that in control group, P〈0.05. （3）The subgroup with histological chorioamnionitis showed a significant increase in serum amyloid A compared with the subgroup without histological chorioamnionitis, P〈0.05. （4）Serum amyloid A levels at a cut-off of 17.55 mg/L showed the highest Youden index for predicting preterm premature rupture of membrane with histological chorioamnionitis. Conclusion Maternal serum amyloid A is closely related to preterm premature rupture of membrane and histological chorioamnionitis.