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目的探讨母血、脐血、新生儿外周血中可溶性白细胞分化抗原14(sCD14),基质金属蛋白8(MMP-8)和可溶性髓样细胞表达触发因子受体1(sTREM-1)的表达水平在胎膜早破(prematureruptureoffetalmembranes,PROM)、绒毛膜羊膜炎和新生儿结局中的临床意义。方法采用双抗体夹心酶联免疫吸附法(ELISA)检测60例胎膜早破孕妇(PROM组)及60名正常孕妇(对照组)母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1表达水平;胎膜早破诊断标准参照第八版《妇产科学》、新生儿感染(新生儿肺炎、新生儿坏死性小肠结肠炎及新生儿败血症)诊断标准参照第四版《实用新生儿学》,行胎膜病理学检查诊断绒毛膜羊膜炎。结果PROM组母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1的水平均高于对照组(P<0.05),且表达水平随破膜时间的延长而升高;绒毛膜羊膜炎组患者母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1表达水平显著高于非绒毛膜羊膜炎组患者,两组比较差异有统计学意义(P<0.05);新生儿围产期感染组的母血、脐血、新生儿外周血中sCD14,MMP-8和sTREM-1表达水平显著高于围产期无感染组(P<0.05)。结论sCD14,MMP-8和sTREM-1在母血、脐血、新生儿外周血中表达水平的变化及联合检测,对PROM、绒毛膜羊膜炎及新生儿围产期感染均具有一定的临床诊断意义。
Objective To investigate the expression of sCD14, sMMP-8 and sTREM-1 in peripheral blood of maternal blood, umbilical cord blood and neonates. In premature rupture of membranes (PROM), chorioamnionitis and neonatal outcomes. Methods The serum levels of sCD14 and MMP-8 in maternal blood, umbilical cord blood and newborn infants were detected in 60 preterm premature rupture pregnant women (PROM group) and 60 normal pregnant women (control group) by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) And sTREM-1 expression levels; diagnostic criteria for premature rupture of membranes refer to the eighth edition of “Obstetrics and Gynecology”, neonatal infections (neonatal pneumonia, neonatal necrotizing enterocolitis and neonatal sepsis) diagnostic criteria with reference to the fourth edition of “ Practical Neonatology ”, line fetal pathology examination of chorioamnionitis. Results The levels of sCD14, MMP-8 and sTREM-1 in maternal blood, umbilical cord blood and neonates were significantly higher in PROM group than those in control group (P <0.05), and the expression levels of sCD14 and MMP-8 increased with the prolongation of rupture time. The levels of sCD14, MMP-8 and sTREM-1 in maternal blood, umbilical cord blood and neonates were significantly higher in membranous amniocentesis than those in non-chorioamnionitis group (P <0.05) ). The expression levels of sCD14, MMP-8 and sTREM-1 in maternal blood, cord blood and neonates were significantly higher in perinatal infection group than those in non-infected perinatal group (P <0.05). Conclusions The changes of sCD14, MMP-8 and sTREM-1 in maternal blood, umbilical cord blood and neonatal peripheral blood and the combined detection of them have some clinical diagnosis to PROM, chorioamnionitis and neonatal perinatal infection significance.