The relationship between the intensity of intra-amniotic inflammation and the presence and severity of acute histologic chorioamnionitis in preterm gestation.
The relationship between the intensity of intra-amniotic inflammation and the presence and severity of acute histologic chorioamnionitis in preterm gestation.
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DOI：
10.3109/14767058.2014.961009
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Yoon BH
中科院分区：
文献类型：
--
作者：
Kim SM;Romero R;Park JW;Oh KJ;Jun JK;Yoon BH
急性组织学绒毛膜炎（HCA）与围产期死亡率和发病率的风险增加有关。本研究的目的是确定早产儿羊水内炎症（IAI）强度与急性HCA严重程度之间的关系。在412例经腹子宫穿刺术后120小时内分娩的单胎患者中，研究了IAI强度与急性HCA的存在和严重程度之间的关系。检测羊水金属蛋白酶（MMP）-8的浓度，以确定IAI的存在和强度。急性HCA定义为根据先前报道的标准（AJOG 1995;172：960-70）在任何组织样品中存在炎性变化。急性HCA的总分级用于确定HCA的严重程度。1)IAI组急性HCA发生率为76.9%（133/173），显著高于非IAI组的20.9%（50/239），P<0.001。急性HCA患者AF MMP-8浓度显著高于非急性HCA患者（中位数[范围]; 188.3ng/mL[0.3-6142.6] vs 1.8ng/mL[0.3-2845.5]，P <0.001）; 2）183例急性HCA患者中，AF MMP-8浓度与急性HCA的严重程度呈正相关（P<0.001）。AF MMP-8浓度不仅是急性HCA存在的预测因子，而且其浓度还与急性HCA的严重程度相关。IAI强度越高，早产儿急性HCA的程度越严重。
Acute histologic chorioamnionitis (HCA) is associated with increased risk of perinatal mortality and morbiditiy. The purpose of this study was to determine the relationship between the intensity of intra-amniotic inflammation (IAI) and the severity of acute HCA in preterm gestation. The relationship between the intensity of IAI and the presence and severity of acute HCA was examined in 412 singleton patients who delivered within 120 hours of transabdominal amniocentesis. The concentration of amniotic fluid (AF) metalloproteinase (MMP)-8 was assayed to determine the presence and intensity of IAI. Acute HCA was defined as the presence of inflammatory change in any tissue samples according to the criteria previously reported (AJOG 1995;172:960–70). The total grade of acute HCA was used to determine the severity of HCA. 1) Patients with IAI had a significantly higher rate of acute HCA than those without IAI [76.9% (133/173)] vs 20.9% (50/239), P<0.001]. The AF MMP-8 concentration was significantly higher in patients with acute HCA than in those without acute HCA (median[range]; 188.3ng/mL[0.3–6142.6] vs 1.8ng/mL[0.3–2845.5], P <0.001); 2) of 183 patients with acute HCA, AF MMP-8 concentration was positively correlated with severity of acute HCA(P<0.001). AF MMP-8 concentration was not only a predictor of presence of acute HCA, but its concentration also correlated with the severity of acute HCA. The higher the intensity of IAI, the worse the degree of acute HCA in preterm gestation.