宫内感染与胎母输血综合征及炎症相关细胞因子的相关性

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摘要目的：探讨宫内感染（IAI）与胎母输血综合征（FMH）及炎症相关细胞因子水平的相关性。方法：收集80例胎膜早破患者。根据产后胎盘脐带病理学检查，合并IAI40例为观察组，剩余40例无IAI为对照组。所有研究对象产前进行外周血胎儿红细胞酸脱（KB）实验和酶联免疫吸附实验检测血清中的IL-6、TNF-α、IL-10水平，分析IAI患者中FMH的发生率及细胞因子变化。结果：我院同期妊娠妇女中，IAI的发生率约为0.54%（40/7 638），观察组KB实验≥0.6% 9例，对照组KB实验≥0.6% 2例，FMH的发生率约为0.14%（11/7 638），在观察组患者中FMH的发生率为22.5%（9/40），对照组为5%（2/40），差异有统计学意义（P＜0.05）。观察组和FMH组妊娠妇女血清中IL-6、TNF-α的含量均高于对照组（P＜0.05），IL-10的含量低于对照组（P＜0.05）。结论：在IAI患者中，FMH的发生率升高；IAI合并FMH患者血清中IL-6、TNF-α水平明显升高，IL-10水平降低，与IAI引起的细胞因子变化相一致。

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关键词 ： , 宫内感染；胎母输血综合征；红细胞脱酸实验；细胞因子

Abstract：Objective: To explore the correlation and changes of serum level of cytokines between intra-amniotic infection (IAI) and feto-maternal hemorrhage (FMH). Methods: Eighty cases of premature rupture of membranes were selected as research object. According to pathological examination of placenta and umbilical cord after childbirth, all cases were assigned into observation group (40 cases) with IAI and control group (40 cases) without IAI respectively. All cases were performed Kleihaue-Betke test and used ELISA to detect serum levels of IL-6, TNF-α and IL-10 antepartum. Incidence of maternal FMH and changes of cytokines in patients with IAI were analyzed. Results: Compared with the total number of pregnant women in our hospital, the incidence of IAI was 0.54% (40/7 638), the incidence of FMH was 0.14% (11/7 638). However, the incidence of FMH in patients with IAI was 22.5% (9/40). The finding showed that 9 cases with Kleihaue-Betke test≥0.6% in observation group and 2 cases with Kleihaue-Betke test≥0.6% in control group. The incidence of FMH was statistically significant (P<0.05). The levels of IL-6 and TNF-α in serum in observation group and FMH group were higher than those in control group and group without FMH (P<0.05). The plasma concentrations of IL-10 was lower (P<0.05). Conclusion: In Patients with IAI, the incidence of FMH is increased. We can find the elevated levels of IL-6, TNF-α in serum and the reduced level of IL-10 in serum in patients with IAI complicating FMH. Changes of cytokines keep consistent with those change induced by IAI.

Key words： intra-amniotic infection feto-maternal hemorrhage Kleihaue-Betke test cytokines

收稿日期: 2017-03-18

基金资助:温州市科技局科研基金资助项目（Y20130197）。

作者简介: 吴丽群（1983-），女，福建莆田人，主治医师，硕士。

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https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I8/604

[1] 王欣, 张为远. 胎母输血综合征7例分析[J]. 中国实用妇科与产科杂志, 2010(7): 546-548.
[2] 乐杰. 妇产科学[M]. 7版. 北京: 人民卫生出版社, 2010: 137.
[3] GREENBERG M B, ANDERSON B L, SCHULKIN J, et al. A first look at chorioamnionitis management practice variation among US obstetricians[J]. Infect Dis Obstet Gynecol, 2012, 2012: 628362.
[4] 回允中. 妇产科诊断病理学[M]. 1版. 北京: 北京大学医学出版社, 2007: 1089.
[5] ADENIJI A O, MABAYOJE V O, RAJI A A, et al. Feto-aternal haemorrhage in parturients: Incidence and its determinants[J]. J Obstet Gynaecol, 2009, 28(1): 60-63.
[6] BIANCHI D W, ROMERO R. Biological implications of bidirectional fetomaternal cell traffic: a summary of a National Institute of Child Health and Human Development-spon-sored conference[J]. J Matern Fetal Neonatal Med, 2003, 14(2): 123-129.
[7] 张志伟, 段明英. 胎母输血综合征[J]. 中国实用妇科与产科杂志, 2011, 27(3): 238-240.
[8] 石岩, 漆洪波. 宫内感染与脑瘫[J]. 实用妇产科杂志, 2009, 23(8): 458-459.
[9] BUHIMSCHI C S, DULAY A T, ABDEL-RAZEQ S, et al. Fetal inflammatory response in women with proteomic biomarkers characteristic of intra-amniotic inflammation and preterm birth[J]. BJOG, 2009, 116(2): 257-267.
[10] ROMERO R, KADAR N, VAISBUCH E, et al. Maternal death following cardiopulmonary collapse after delivery: amniotic fluid embolism or septic shock due to intrauterine infection?[J]. Am J Reprod Immunol, 2010, 64(2): 113-125.
[11] 吴丽群, 高洁, 蔡平生, 等. 产时感染性发热对围生儿预后的影响[J]. 温州医科大学学报, 2014, 44(9): 682-684.
[12] 李雪花, 程蔚蔚, 沈月华. 大量胎母输血11例分析[J]. 中华围产医学杂志, 2010, 13(1): 63-64.
[13] LEDUC L, MOISE K J JR, CARPENTER R J JR, et al. Fetoplacental blood volume estimation in pregnancies with Rh alloimmunization[J]. Fetal Diagn Ther, 1990, 5(3-4): 138-146.