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目的:探讨未足月胎膜早破(PPROM)合并绒毛膜羊膜炎(HCA)孕妇血清中中性粒细胞弹性蛋白酶(NE)、氧化型α1-抗胰蛋白酶(Ox-AT)及白细胞介素-8(IL-8)水平变化及对妊娠结局的影响。方法:选择2015年3月至2016年2月我院收治的PPROM孕妇86例,根据患者是否合并HCA分为HCA组(n=46)和非HCA组(n=40),HCA组包括轻度(n=16)、中度(n=15)和重度(n=15),同期选择来我院进行产检的正常孕妇45例作为对照组。应用酶联免疫吸附测定法测定孕妇产前血清NE、Ox-AT及IL-8水平,对比其在不同组孕妇间的差异,分析HCA与PPROM孕妇的妊娠结局的关系。结果:HCA组及非HCA组孕妇血清NE、Ox-AT及IL-8水平均显著高于对照组,且HCA组均显著高于非HCA组,差异均具有统计学意义(P<0.05)。随着HCA的程度加重,孕妇血清中NE、Ox-AT及IL-8水平明显升高,分别与HCA严重程度呈正相关(r=0.732、0.694、0.787;均P<0.05)。HCA组中孕妇产后出血率、剖宫产率及早产儿肺炎率明显高于非HCA组,而Apgar评分显著低于非HCA组,差异均具有统计学意义(P<0.05)。结论:血清NE、Ox-AT及IL-8与PPROM合并HCA孕妇的发生、发展有关,及时检查上述指标有助于改善此类孕妇的妊娠结局。
Objective: To investigate the changes of neutrophil elastase (NE), oxidized α1-antitrypsin (Ox-AT) and interleukin (IL) in pregnant women with unexposed term premature rupture of membranes (PPROM) and chorioamnionitis (HCA) -8 (IL-8) levels and the impact on pregnancy outcome. Methods: Eighty-six PPPP pregnant women who were admitted to our hospital from March 2015 to February 2016 were divided into HCA group (n = 46) and non-HCA group (n = 40) according to whether they were combined with HCA. HCA group included mild (n = 16), moderate (n = 15) and severe (n = 15). Forty-five pregnant women, who were selected for antenatal checkup in our hospital, were selected as the control group. The serum levels of NE, Ox-AT and IL-8 in prenatal serum of pregnant women were determined by enzyme-linked immunosorbent assay (ELISA), and the differences between HCA and PPROM pregnant women were analyzed. Results: Serum levels of NE, Ox-AT and IL-8 in HCA group and non-HCA group were significantly higher than those in control group, and HCA group was significantly higher than non-HCA group (P <0.05). With the aggravation of HCA, the levels of NE, Ox-AT and IL-8 in serum of pregnant women were significantly increased, which were positively correlated with the severity of HCA (r = 0.732,0.694,0.787; all P <0.05). HCA group, postpartum hemorrhage rate, cesarean section rate and preterm infants pneumonia rate was significantly higher than non-HCA group, while Apgar score was significantly lower than non-HCA group, the difference was statistically significant (P <0.05). Conclusion: Serum levels of NE, Ox-AT and IL-8 are associated with the occurrence and development of pregnant women with PPROM combined with HCM. Examining these indexes in time can improve the pregnancy outcome of these pregnant women.