感染性早产产妇血清MCP-1与sTNFR-Ⅰ和HMGB1及TNF-α的表达

Expression of serum MCP-1,sTNFR-Ⅰ,HMGB1 and TNF-α expression in women with infective premature delivery

目的探讨感染性早产产妇血清单核细胞趋化蛋白-1(Monocyte chemo attractant protein-1,MCP-1)、可溶性肿瘤坏死因子受体I(Soluble tumor necrosis factor receptor I,sTNFR-Ⅰ)、高迁移率族蛋白(High mobility group box 1,HMGB1)、肿瘤坏死因子-α(TNF-α)的表达及临床意义,为感染性早产的防治提供参考。方法选取2016年1月-2017年12月于医院住院分娩的早产产妇100例为研究对象并设为早产组,选取同期住院分娩的足月产产妇100例设为足月组,检测两组产妇MCP-1、sTNFR-Ⅰ、HMGB1、TNF-α在胎盘分娩出后取胎盘组织标本检测绒毛膜羊膜炎情况。结果两组共有52例检测提示绒毛膜羊膜炎,其中早产组绒毛膜羊膜炎检出率为44.00%(44/100)高于足月组8.00%(8/100)(P<0.001);早产组产妇血清MCP-1、sTNFR-Ⅰ、HMGB1、TNF-α分别为(17.83±3.63)pg/ml、(45.29±18.51)pg/ml、(6.63±0.49)mg/L、(64.19±24.66)pg/ml高于足月组(P<0.05);感染性早产产妇血清MCP-1、sTNFR-Ⅰ、HMGB1、TNF-α分别为(21.31±3.30)pg/ml、(50.65±16.66)pg/ml、(6.87±0.49)mg/L、(70.23±20.34)pg/ml高于非感染性早产产妇(P≤0.001)。感染性足月产产妇血清MCP-1、sTNFR-Ⅰ、HMGB1、TNF-α水平分别为14.97(13.53,16.24)pg/ml、36.77(28.27,49.31)pg/ml、1.05(0.85,1.18)mg/L、54.48(40.97,67.03)pg/ml高于非感染性足月产产妇(P<0.05)。结论早产产妇存在血清MCP-1、sTNFR-Ⅰ、HMGB1、TNF-α表达上调,尤其是感染性早产产妇以上指标升高更为明显,以上指标可作为感染性早产的预测指标。

OBJECTIVE To explore the expression and clinical significance of serum monocyte chemotactic protein 1(MCP-1),soluble tumor necrosis factor receptorⅠ(sTNFR-Ⅰ),high-mobility group box-1(HMGB1),tumor necrosis factorα(TNF-α)in women with infective premature delivery,so as to provide reference for the prevention and treatment of infective premature delivery.METHODS 100 cases of preterm parturient women gave birth in the hospital during Jan.2016 to Dec.2017 were enrolled into the study and set as the preterm group,and another 100 cases of full-term parturient women were set as the full-term group.The MCP-1,sTNFR-Ⅰ,HMGB1,and TNF-αwere determined for both groups,and the placental samples were taken for the detection of chorionic amnitis after the placenta was delivered.RESULTS 52 cases of the two groups were examined with chorionic amnitis,44 cases of preterm group and 8 cases of full-term group,with detection rates of 44.00%(44/100)and 8.00%(8/100),the difference was significant(P<0.001).MCP-1 was(17.83±3.63)pg/ml,sTNFR-Ⅰwas(45.29±18.51)pg/ml,HMGB1 was(6.63±0.49)mg/L,and TNF-αwas(64.19±24.66)pg/ml in the preterm group,significantly higher than those of the full-term group,(P<0.05).MCP-1 was(21.31±3.30)pg/ml,sTNFR-Ⅰwas(50.65±16.66)pg/ml,HMGB1 was(6.87±0.49)mg/L,and TNF-αwas(70.23±20.34)pg/ml in the women with infective premature delivery,significantly higher than those of women with non-infective premature delivery,(P≤0.001).MCP-1 was 14.97(13.53,16.24)pg/ml,sTNFR-Ⅰwas 36.77(28.27,49.31)pg/ml,HMGB1 was1.05(0.85,1.18)mg/L,and TNF-αwas 54.48(40.97,67.03)pg/ml in infective full-term parturient women,significantly higher than those of non-infective full-term parturient women(P<0.05).CONCLUSIONExpression levels of serum MCP-1,sTNFR-Ⅰ,HMGB1,TNF-αwere elevated in preterm parturient women,in particular in those with infective premature delivery,and the above indicators can be used as predictors of infectious preterm birth.