A study on relationship between chorioamnionitis and fetal lung maturation.

我们以前报道过羊膜绒毛膜炎（CAM）患者的羊膜表面活性剂浓度明显高于无CAM患者。此外，最近有报道称，患有CAM的孕妇所生婴儿的RDS发生率显著降低。我们在两个实验中研究了内毒素或细胞隐素是否能促进胎兔肺表面活性物质的产生。1)孕兔在妊娠24-25 d时静脉注射0.1 ~ 100ug/kg的内毒素（脂多糖，LPS）。妊娠26 d行剖宫产取胎肺。LPS显著刺激了胎兔肺切片中氯化胆碱与磷脂酰胆碱（PC）的结合。与妊娠28天胎儿肺掺入率相关。在培养液中加入LPS并没有促进胆碱在PC中的掺入。然而，加入白细胞介素6刺激胆碱在胎兔肺片的掺入。2)采用聚乙烯管微型泵向胎膜与子宫壁间隙灌注LPS或细胞导管，建立孕兔宫内感染模型。结果表明，LPS、IL-6、IL-8和tnf - α可显著增强妊娠第19天胎儿肺表面活性物质载脂蛋白A m-RNA的表达。总之，我们的研究结果表明，在宫内感染期间，胎儿肺成熟被刺激。

We previously reported that the amniotic surfactant concentrations in the patients with chorioamnionitis(CAM) was signuficantly higher than that in the patients without CAM.Moreover, recently it was reported that the occurrence of RDS was significantly reduced in infants who were born of pregnant womem with CAM.We investigated whether lung surfactant production in fetal rabbit lung could be enhanced by endotoxin or cytocain in two experiments described below. 1) Endotoxin (lipopolysaccharide, LPS) of 0.1-100ug/kg was administered intravenously to pregnant rabbits at 24-25 days of gestation. On 26 days of gestation fetal lungs were obtained by cesarean section. LPS was significantly stimulated the incorporation of choline chloride into phosphatidylcholine (PC) in fetal rabbit lung slices. It coresponded to the incorporation rate of fetal lung on 28 days of gestation. LPS added into incubation medium did not enhanc the incorporation of choline in to PC.However, Interleukin 6 added into the medium stimulated the incorporation of choline in fetal rabbit lung slices. 2) We made a model of intrauterine infection of pregnant rabbits by infusion of LPS or cytocains into space between fetal membrans and uterine wall using minipump with a polyethylene tube. Administration of LPS,IL-6, IL-8 and TNF-alpha was shown to enhance significantly the appearance of m-RNA of pulmonary surfactant apo-protein A in fetal lung at 19 days of gestation.In conclusion, it was suggested that fetal lung maturation was stimurated during intrauterine infection from the results of our studies.