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目的:探讨宫颈管微生物阳性及HMGB1在早产发病机制中的作用,为预防早产及治疗感染所致先兆早产开拓新思路。方法:选取2014年8月至2015年1月中南大学湘雅医院产科收治的20例早产及20例足月分娩孕妇。取患者宫颈分泌物行病原微生物培养,胎盘组织做HE染色检测绒毛膜羊膜炎,免疫组化检测HMGB1表达。结果:早产组孕妇的宫颈管微生物阳性率和HMGB1表达高于足月分娩组,差异均有统计学意义(P<0.05)。合并宫颈管微生物阳性的早产组孕妇胎盘组织中HMGB1表达较其他各亚组均明显增高,差异有统计学意义(P<0.05)。4例合并宫颈管微生物阳性的早产孕妇的胎盘诊断为绒毛膜羊膜炎。结论:妊娠期宫颈管内微生物可能通过促进胎盘组织中HMGB1表达,诱发并加重炎症反应,导致早产。
OBJECTIVE: To explore the role of cervical microbiocenosis and HMGB1 in the pathogenesis of preterm birth and to explore new ideas for preventing preterm birth and treating premature infants with infection. Methods: From August 2014 to January 2015, 20 cases of preterm delivery and 20 full term pregnant women were enrolled in the obstetrics and gynecology department of Xiangya Hospital of Central South University. Take the patient’s cervical secretions pathogenic microorganism culture, placental tissue to do chorioamnionitis HE staining, immunohistochemical detection of HMGB1 expression. Results: The positive rates of cervical microbe and HMGB1 in preterm labor group were higher than those in term delivery group (P <0.05). Compared with other subgroups, the expression of HMGB1 in placental tissue of pregnant women with cervical microbe-positive preterm labor group was significantly higher (P <0.05). Four cases of preterm pregnant women with cervical canal microbiology positive had placenta diagnosis of chorioamnionitis. Conclusion: The cervical intracapsular microorganisms in pregnancy may promote the HMGB1 expression in the placenta, induce and aggravate the inflammatory reaction, and lead to premature delivery.