Diagnostic value of placental NLRP3,TLR4 and Fasl levels in intrauterine infection in preterm women with premature rupture of membranes
OBJECTIVE To investigate the diagnostic value of the Nod-like receptor heat protein domain associated protein 3,(NOd-like receptor heat protein domain associated protein 3,NLRP3),Toll-like receptor 4(TLR4)and Fatty acid synthase ligand(Fasl)levels in intrauterine infection in preterm women with premature rupture of membranes.METHODS Clinical data of 172 preterm women with premature rupture of membranes admitted to Si-chuan People's Hospital from Mar.2021 to Mar.2023 were retrospectively analyzed,and they were divided into the infected group of 53 cases and the non-infected group of 119 cases according to the intrauterine infection.The clinical data of the two groups were analyzed,and the risk factors of intrauterine infection in women with preterm premature rupture of membranes were summarized.The positive rate of NLRP3 expression,and the levels of TLR4 and Fasl in placenta were detected by immunohistochemistry and RT-qPCR,respectively.The positive rate of NLRP3 and the expression levels of TLR4 and Fasl were compared between the two groups.The receiver oper-ating characteristic(ROC)curve was used to analyze the diagnostic value of NLRP3,TLR4 and Fasl alone and in combination for intrauterine infection in preterm premature rupture of membranes.RESULTS The number of vagi-nal examinations,pregnancy week,NLR,RDW and PCT were the risk factors of intrauterine infection in preterm women with premature rupture of membranes(P＜0.05).The positive expression rate of NLRP3,and the levels of TLR4 and Fasl were higher in the infected group than in the non-infected group(P＜0.05).According to ROC curve,AUC of NLRP3,TLR4 and Fasl alone and in combination for the diagnosis of intrauterine infection in pre-term women with premature rupture of membranes were 0.787,0.744,0.721 and 0.917,respectively,and the AUC of combined tests was higher than that of each single test(P＜0.05),and with the sensitivity and specificity of the combined detection being 84.90％and 84.00％,respectively.CONCLUSION The placenta NLRP3,TLR4 and Fasl were highly expressed in intrauterine infection patients with preterm premature rupture of membranes.The combined detection of NLRP3,TLR4 and Fasl was helpful for the diagnosis of intrauterine infection in pre-term women with premature rupture of membranes.The number of vaginal examinations,pregnancy week,NLR,RDW and PCT were risk factors for intrauterine infection in preterm women with premature rupture of membranes.
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