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目的分析孕产妇外周血中α黑色素细胞刺激素(α-MSH)、白介素-6(IL-6)、NF-κB在晚期流产和早产中的表达及临床意义。方法选取2011年2月-2015年1月该院收治的晚期流产或早产的孕产妇100例为研究组,其中晚期难免流产、晚期先兆流产、早产、先兆早产各25例。另选取同期中孕引产(中孕引产组)、正常妊娠(正常妊娠组)产妇各25例为对照组。采用ELISA法检测各组血清中α-MSH、IL-6及NF-κB的水平。结果研究组的生殖道感染率显著升高,其中流产组与早产组生殖道感染与绒毛膜羊膜炎存在相关性。与中孕引产组和难免流产组比较,先兆流产组α-MSH表达显著升高(P<0.01);与早产组和正常妊娠组比较,先兆早产组中α-MSH水平显著增高(P<0.01);与中孕引产组比较,难免流产组与先兆流产组中IL-6水平增高,其中难免流产组中IL-6水平最高;与正常妊娠组比较,早产组及先兆早产组IL-6水平显著升高(P<0.01)。6组NF-κB的表达水平比较,差异均无统计学意义(P>0.05)。结论孕中期生殖道感染是影响早产与流产的重要因素;α-MSH具有调动机体抗炎机制的能力,其水平可反映机体抗炎能力强弱,α-MSH及IL-6的检测可预防早产和流产的发生及预后。外周血NF-κB不能作为流产的单独预测指标。
Objective To analyze the expression and clinical significance of α-MSH, IL-6 and NF-κB in the abortion and premature delivery in maternal blood. Methods A total of 100 pregnant women with advanced miscarriage or prematurity admitted to our hospital from February 2011 to January 2015 were selected as the study group. Among them, 25 were suspected of abortion, advanced threatened abortion, premature delivery and threatened preterm delivery. Another select the same period of middle pregnancy induced labor (induction of labor in the second trimester), normal pregnancy (normal pregnancy group) 25 cases of pregnant women as the control group. Serum levels of α-MSH, IL-6 and NF-κB were detected by ELISA. Results The study group of genital tract infection rate was significantly higher, abortion group and preterm birth group genital tract infection and chorioamnionitis there is a correlation. The α-MSH expression in threatened abortion group was significantly higher than that in the preeclampsia group and the normal pregnancy group (P <0.01) ); Compared with the second trimester induction group, the levels of IL-6 in the unavoidable abortion group and the threatened abortion group were increased, and the level of IL-6 in the unavoidable abortion group was the highest. Compared with the normal pregnancy group, the IL-6 level in the preterm labor group and the threatened preterm labor group Significantly increased (P <0.01). The expression of NF-κB in 6 groups showed no significant difference (P> 0.05). Conclusions The second trimester genital tract infection is an important factor affecting preterm birth and abortion. Α-MSH has the ability of mobilizing the anti-inflammatory mechanism of the body, and its level can reflect the anti-inflammatory ability of the body. The detection of α-MSH and IL-6 can prevent preterm birth And the occurrence and prognosis of abortion. Peripheral blood NF-κB can not be used as a separate predictor of miscarriage.