Relationship of serum sTLR4,IL-22 R1,PAF with premature rupture of fetal membrane complicated with chorionic amniotic inflammation and early onset sepsis
Objective To investigate the changes of serum soluble Toll-like receptor 4 (sTLR4),interleukin 22 receptor 1 (IL-22R1) and platelet activation factor (PAF) levels in premature rupture of mem-branes with chorioamnionitis (CAM) and the predictive value for early onset neonatal sepsis (EONS).Methods A total of 122 parturients with PROM of Obstetrics and Gynecology Department of Zhengzhou Cen-tral Hospital Affiliated to Zhengzhou University were retrospectively selected as the research subjects.The par-ticipants were divided into two groups:the CAM group and the non-CAM group based on the pathological re-sults of placenta.The changes of sTLR4,IL-22 R1 and PAF levels were analyzed in PROM combined with cho-rioamnionitis.Additionally,the rats were divided into the EONS group and the non-EONS group based on the follow-up results,and the predictive value of sTLR4,IL-22 R1 and PAF levels on the occurrence of EONS was analyzed.Results Forty-six out of 122 parturients with PROM were complicated with CAM,and the inci-dence rate was 37.70％.Seventy-six parturients without CAM accounted for 62.30％.The levels of WBC,PLT,CRP,sTLR4,IL-22 R1 and PAF in the CAM group were higher than those in the non-CAM group,the differ-ence had statistical significance (t=23.063,15.534,17.763,8.988,12.588,6.352,P<0.05).Multivariate logis-tic regression analysis showed that the increase in IL-22 R1 and PAF levels is closely related to the occurrence of premature rupture of membranes combined with CAM (P<0.05).Among the 122 cases of premature rupture of membranes,16 cases (13.11％) experienced EONS,and 106 cases (86.89％) did not experience EONS.The levels of CAM proportion,sTLR4,IL-22 R1 and PAF in the EONS group were higher than those in the non-EONS group,the difference had statistical significance (x2=4.820,t=6.935,4.938,3.577,P<0.05).Multi-variate logistic regression analysis showed that the increase in CAM,sTLR4 and IL-22 R1 levels were closely related to EONS in women with premature rupture of membranes (P<0.05).The combined ROC-AUC was 0.851(0.770～0.933),the sensitivity was 81.3％,and the specificity was 79.2％.Conclusion Serum levels of sTLR4,IL-22 R1,and PAF were significantly increased in premature rupture of membranes combined with CAM,which was closely related to the occurrence of CAM and EONS.The combined detection of these three indicators had significant clinical value in predicting the occurrence of EONS.
万方数据
维普
