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- Title
TNF-α、IL-6、IL-17 在胎膜早破母儿感染相关不良 妊娠结局中的表达及临床价值.
- Authors
赵 倩; 何 霞; 凌 娅; 可饶阳; 李赛男; 黄 蓉; 祁文瑾
- Abstract
Objective To investigate the clinical value of expression levels of TNF- α、IL-6、IL-17 in the maternal serum and umbilical cord serum in the premature rupture of membranes (PROM) with chorioamnionitis (CS) and PROM with the neonatal infection during the perinatal period. Methods 51 patients with the premature rupture of membrane who had been admitted to the Obstetrics Department of the First Affiliated Hospital of Kunming Medical University were enrolled as PROM group. At the same time,20 normal maternities delivered in this hospital were adopted to the control group. Double antibody sandwich ELISA was used to detect the expression levels of TNF- α,IL-6 and IL-17 in the maternal serum and umbilical cord serum. After that,the PROM group was regrouped into PROM with CS group and PROM without CS group,PROM without the neonatal infection during the perinatal (group A1) and PROM with the neonatal infection during perinatal (group A2). Comparing the expression levels of these three indicators in the maternal serum and umbilical cord serum of different groups and using ROC curve to analyze the value of these indexes above in predicting the premature ruptured of membranes with adverse pregnancy outcomes associated with maternal and fetal infection. Result (1) The levels of TNF-α and IL-6 in the maternal serum and umbilical cord serum in PROM with CS group were statistically higher than those in PROM without CS group and the control group (P < 0.05). The levels of TNF-α in the maternal serum and the levels of IL-6 in the umbilical cord serum in the PROM without CS group were statistically higher than those in the control group (P < 0.05). (2) Expression levels of TNF-α,IL-6 and IL-17 in the maternal serum and umbilical cord serum of A2 group were statistically higher than those of A1 group and the control group (P < 0.05). The levels of TNF-α in the maternal serum and the levels of IL-6 in the umbilical cord serum of A1 group were significantly higher than those of the control group (P < 0.05). (3) The expression level of TNF-α、IL-6 and IL-17 in the maternal serum and in the umbilical cord serum were significantly positively correlated (P < 0.001). (4) In the diagnosis of PROM with CS, TNF-α in the maternal serum was of the biggest area under the curve (AUC) among all single index (0.763). The AUC of TNF-α in the maternal serum was bigger than that in the umbilical cord serum (0.614)(P < 0.05). When four indexes were used in combination, the AUC of TNF-α+IL-6 in the maternal serum combined with TNF- α+IL-6 in the umbilical cord serum (0.820) was bigger than that of single detection of TNF-α in the umbilical cord serum (0.614)(P < 0.05). (5) In the diagnosis of PROM with the neonatal infection during perinatal,IL-6 was of the biggest AUC among all single index in the maternal serum (0.800) and IL-17 was of the biggest AUC among all single index in the umbilical cord serum (0.829). The AUC of IL-17 in the umbilical cord serum was bigger than that in the maternal serum (0.735)(P < 0.05). Two indexes combined of IL-6+ IL-17 or Three indexes combined of TNF-α+ IL-6+ IL-17 in the umbilical cord serum was of great diagnostic value ( AUC: 0.863、0.866) . Conclusion TNF-α,IL-6 and IL-17 in the maternal serum and umbilical cord serum are of great predictive value for predicting PROM with CS and PROM with the neonatal infection during the perinatal period. The diagnostic value of joint detection is better. In clinical work,detection of the three indexes in the maternal serum also has a good value of the clinical application when collecting of the umbilical cord serum is limited.
- Publication
Journal of Kunming Medical University / Kunming Yike Daxue Xuebao, 2021, Vol 42, Issue 9, p101
- ISSN
2095-610X
- Publication type
Article
- DOI
10.12259/j.issn.2095-610X.S20210940