上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (8): 955-.

• 论著（临床研究） • 上一篇    下一篇

母体血浆胎盘亮氨酸氨肽酶和白介素-6与自发性早产的关系

熊 瑛1, 杨祖菁2   

  1. 1. 温州医学院,  温州 325035；2. 上海交通大学 医学院新华医院妇产科, 上海 200092
  • 出版日期:2009-08-25 发布日期:2009-09-27
  • 通讯作者: 杨祖菁, 电子信箱: yzujing@sohu.com。
  • 作者简介:熊瑛（1976—）, 女, 主治医师, 学士；电子信箱: yin_xion@hotmail.com。
  • 基金资助:

    上海交通大学医学院附属新华医院基金(07YJ12)

Correlation of maternal plasma placental leucine aminopepticlase and interleukin-6 with spontaneous preterm labor

XIONG Ying1, YANG Zu-jing2   

  1. 1. Wenzhou Medical College, Wenzhou 325035, China；2. Department of Obstetrics and Gynaecology, Xinhua Hospital, School of Medicine, Shanghai Jiatong University, Shanghai 200092, China
  • Online:2009-08-25 Published:2009-09-27
  • Supported by:

    Foundation from Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 07YJ12

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摘要：

目的 分析自发性早产孕妇孕晚期血浆中胎盘亮氨酸氨肽酶（P-LAP）和白介素-6（IL-6）的变化情况。 方法 酶联免疫吸附试验（ELISA法）测定并比较早产组（n=52）、先兆早产组(n=33)和对照（足月分娩）组（n=137）孕妇孕晚期血浆中P-LAP和IL-6的水平。在早产组中，比较早产伴亚临床绒毛膜羊膜炎（SC）孕妇（n=41）与早产不伴SC孕妇(n=11)P-LAP和IL-6水平的差异。受试者工作特征（ROC）曲线分析自发性早产孕妇血浆中P-LAP和IL-6水平预测不可避免早产的截点；Pearson检验分析P-LAP和IL-6的相关性。 结果 早产组血浆P-LAP和IL-6水平均低于先兆早产组和对照组（P<0.01）；而对照组与先兆早产组比较，差异无统计学意义（P>0.05）。伴或不伴SC的早产孕妇血浆P-LAP 和IL-6比较，差异均无统计学意义（P>0.05）。根据ROC曲线得出，以P-LAP≤38.12 U/L和IL-6≥3.40 pg/mL为截点,可用来预测不可避免早产；P-LAP与IL-6联合预测不可避免早产的约登指数较单独检测明显提高（P<0.05）。自发性早产孕妇血浆P-LAP和IL-6水平相关（r=-0.311，P=0.025）。 结论 对有自发性早产先兆的孕妇进行P-LAP和IL-6联合检测，能更准确地预测早产；IL-6等促炎症细胞因子分泌增多，导致P-LAP水平下降，可能是自发性早产的关键因素。

关键词: 胎盘亮氨酸氨肽酶, 白介素-6, 早产, 先兆早产

Abstract:

Objective To analyse the changes of maternal plasma placental leucine aminopepticlase (P-LAP) and interleukin-6 (IL-6) levels during third trimester in spontaneous preterm labor. Methods Maternal plasma P-LAP and IL-6 levels were detected by enzyme-linked immunosorbent assay in preterm labor group（n=52）, threatened preterm labor group (n=33) and control （normal labor）group (n=137). In preterm labor group, the P-LAP and IL-6 levels of the pregnant women with subclinical chorioamnionitis (SC) (n=41）were compared with those without SC (n=11). ROC curve was employed to analyse the maternal plasma P-LAP and IL-6 levels of spontaneous preterm labor to predict the inevitable preterm labor, and the correlation of P-LAP and IL-6 was explored with Pearson analysis. Results The plasma P-LAP and IL-6 levels in preterm labor group were lower than those in threatened preterm labor group and control group（P<0.01）, while there was no significant difference between control group and threatened preterm labor group（P>0.05）. There was no significant difference in plasma P-LAP and IL-6 levels between the pregnant women with SC and those without SC (P>0.05）. It was revealed by ROC curve analysis that P-LAP≤38.12 U/L and IL-6≥3.40 pg/mL could be adopted as criteria to predict the inevitable preterm labor, and the Youden's index of the combination use of the parameters of P-LAP and IL-6 was significantly higher than that of the single use of each parameter（P<0.05）. Maternal plasma P-LAP level was correlated to IL-6 level（r=-0.311，P<0.01）. Conclusion Preterm labor can be more accurately predicted by combination detection of plasma P-LAP and IL-6. The oversecretion of IL-6 may lead to the decrease of P-LAP, which may be the key factor for spontaneous preterm labor.

Key words: placental leucine aminopepticlase, interleukin-6, preterm labor, threatened preterm labor

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