胎膜早破合并宫内感染致早产者血清AMH、IL-6、IL-8、TNF-α水平变化及临床意义

Changes and clinical significance of serum anti Mullerian hormone,interleukin(IL)-6,IL-8,and tumor necrosis factor al-pha levels of women with preterm premature rupture of membranes complicated with intrauterine infection

目的:观察胎膜早破早产(PPROM)合并宫内感染孕产妇的血清抗苗勒氏管激素(AMH)、白介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)水平变化及其临床意义.方法:选择2020年1月—2021年8月本院收治的PPROM孕产妇86例临床资料,其中合并宫内感染47例为感染组,未合并宫内感染39例为非感染组;破膜时间<24h55例,≥24h31例.胎膜完整早产者40例为对照组.比较各组血清AMH、IL-6、IL-8、TNF-α水平.结果:血清AMH、IL-6、IL-8、TNF-α水平感染组、非感染组、对照组依次降低(P<0.05);破膜时间≥24h组血清IL-6、IL-8、TNF-α水平高于破膜时间<24h组(P<0.05),AMH水平不同破膜时间组间未见差异(P>0.05).Spearman相关性分析显示,AMH与血清TNF-α呈相关性(P<0.05),与IL-6、IL-8无相关性(P>0.05);TNF-α、IL-6、IL-8间呈正相关性(P<0.05).结论:PPROM孕产妇血清AMH、IL-6、IL-8、TNF-α水平异常高表达,且破膜时间越长、合并感染者血清IL-6、IL-8、TNF-α水平升高,提示临床该指标对PPROM尤其是合并宫内感染的早期识别可能有价值.

Objective: To investigate the serum changes and clinical significance of serum anti Mullerian hormone(AMH),interleukin(IL)-6, IL-8, and tumor necrosis factor alpha(TNF-α) levels of women with preterm premature rupture of membranes(PPROM) complicated with intrauterine infection. Methods: The clinical data of 86 pregnant women with PPROM from January 2020 to August 2021 were selected in this study. Among them, 47 cases with intrauterine infection were included in group A,and 39 cases without intrauterine infection were included in group B. And these women were also divided in group C(55 cases with premature rupture of membranes time <24 h) and group D(31 cases with premature rupture of membranes time≥24 h). Another 40 women with preterm birth and intact fetal membranes were selected in control group during the same period. The levels of serum AMH,IL-6,IL-8, and TNF-α of the women were compared among these groups. Results: The serum levels of AMH, IL-6, IL-8, and TNF-α of the women in group A, group B, and group C had decreased gradually(P<0.05). The serum levels of IL-6, IL-8, and TNF-α of the women in group D were significantly higher than those of the women in group C(P<0.05), but there was no significant difference in the AMH level of the women between group C and group D(P>0.05). Spearman correlation analysis showed that the AMH level of the women was correlated with their serum TNF-α level(P<0.05), but was no correlation with their IL-6 and IL-8 levels(P>0.05). The levels of TNF-α, IL-6, and IL-8 of the women were positively correlated(P<0.05). Conclusion: The levels of the serum AMH,IL-6,IL-8, and TNF-α of the pregnant women with PPROM are high expression obviously, and the levels of serum IL-6,IL-8, and TNF-of the women increase with the longer their membrane rupture time and the complicating of intrauterine infection. It is suggested that the levels of the serum AMH,IL-6,IL-8,and TNF-αof the pregnant women may be valuable for early identification of PPROM,especially for those women complicated with intrauterine infection.