胎膜早破合并绒毛膜羊膜炎血清NLRP3、sTNFR-Ⅰ、miR-182水平及其预测价值

Serum NLRP3,sTNFR-Ⅰ and miR-182 of premature rupture of fetal membrane puerpera complicated with chorioamnionitis and their predictive values

目的为探究胎膜早破(PROM)合并绒毛膜羊膜炎(CA)血清NOD样受体热蛋白结构域相关蛋白3(NLRP3)、可溶性肿瘤坏死因子受体-Ⅰ(sTNFR-Ⅰ)、微小核糖核酸(miR)-182水平及其预测价值。方法选取2019年1月-2023年6月天津市第五中心医院收治的PROM合并CA产妇52例为研究组,另选同期收治的PROM未合并CA产妇54例为对照组,研究组根据CA分期分为I期组25例和Ⅱ~Ⅲ期组27例。比较研究组和对照组、不同CA分期血清NLRP3、sTNFR-Ⅰ、miR-182水平;Spearman分析PROM产妇血清NLRP3、sTNFR-Ⅰ、miR-182水平与CA分期的相关性,受试者工作特征(ROC)曲线分析三指标对PROM合并CA的预测价值。结果与对照组相比,研究组血清NLRP3、sTNFR-Ⅰ、miR-182水平升高(P<0.05);与Ⅰ期组相比,Ⅱ~Ⅲ期组血清NLRP3、sTNFR-Ⅰ、miR-182水平升高(P<0.05);血清NLRP3、sTNFR-Ⅰ、miR-182水平与CA分期呈正相关(P<0.05);血清NLRP3、sTNFR-Ⅰ、miR-182联合检测诊断PROM合并CA的曲线下面积(AUC)比单个指标检测值高(P<0.05),且联合检测的敏感度、特异度为86.54%、90.74%。结论PROM产妇合并CA血清NLRP3、sTNFR-Ⅰ、miR-182水平呈高表达,三指标与CA分期呈正相关,且三指标联合检测可提高PROM产妇合并CA的预测价值。

OBJECTIVE To explore the levels of serum NOD-like receptor protein 3(NLRP3),soluble tumor nec-rosis factor receptor-Ⅰ(sTNFR-Ⅰ)and microribonucleic acid(miR)-182 of the premature rupture of fetal mem-brane(PROM)puerpera complicated with chorioamnionitis(CA)and analyze the predictive value.METHODS A total of 52 PROM puerpera complicated with CA who were treated in Tianjin Fifth Central Hospital from Jan 2019 to Jun 2023 were assigned as the study group,meanwhile,54 PROM puerpera who were not complicated with CA were chosen as the control group.The puerpera of the study group were divided into the stage Ⅰ group with 25 ca-ses and the stage Ⅱ~Ⅲ with 27 cases according to the stage of CA.The levels of serum NLRP3,sTNFR-Ⅰ and miR-182 were compared between the study group and the control group and between the stage Ⅰ group and the stage Ⅱ~Ⅲ group.Spearman analysis was performed for the association between the levels of serum NLRP3,sTNFR-Ⅰ,miR-182 and the stage of CA.The values of the three indexes in prediction of CA in the PROM puerpera were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of serum NLRP3,sTNFR-Ⅰ and miR-182 of the study group were significantly higher than those of the control group(P<0.05).The levels of serum NLRP3,sTNFR-Ⅰ and miR-182 of the stage Ⅱ~Ⅲ group were significantly higher than those of the stage I group(P<0.05).The levels of serum NLRP3,sTNFR-Ⅰ and miR-182 were positively correlated with the stage of CA(P<0.05).The area under curve(AUC)of the joint detection of serum NLRP3,sTNFR-Ⅰ and miR-182 was significantly higher than that of the single detection in diagnosis of CA in the PROM puerpera(P<0.05),the sensitivity of the joint detection was 86.54%,with the specificity 90.74%.CONCLUSION The PROM puerpera complicated with CA show high expressions of serum NLRP3,sTNFR-Ⅰ and miR-182,the three indexes are positively correlated with the stage of CA,and the joint detection of the three indexes has high value in prediction of CA in the PROM puerpera.