Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, MD, USA.
Am J Reprod Immunol. 2010 May;63(5):358-69. doi: 10.1111/j.1600-0897.2010.00809.x. Epub 2010 Feb 18.
Resistin, originally described as an adipokine, has emerged as a potent pro-inflammatory protein associated with both acute and chronic inflammation. Moreover, resistin has been proposed as a powerful marker of sepsis severity, as well as a predictor of survival of critically ill non-pregnant patients. The aim of this study was to determine whether pyelonephritis during pregnancy is associated with changes in maternal plasma resistin concentrations.
This cross-sectional study included the following groups: (i) normal pregnant women (n = 85) and (ii) pregnant women with pyelonephritis (n = 40). Maternal plasma resistin concentrations were determined by ELISA. Non-parametric statistics was used for analyses.
(i) The median maternal plasma resistin concentration was higher in patients with pyelonephritis than in those with a normal pregnancy (P < 0.001); (ii) among patients with pyelonephritis, the median maternal resistin concentration did not differ significantly between those with and without a positive blood culture (P = 0.3); (iii) among patients with pyelonephritis who were diagnosed with systemic inflammatory response syndrome (SIRS), those who fulfilled > or =3 criteria for SIRS had a significantly higher median maternal plasma resistin concentration than those who met only two criteria; and (iv) maternal WBC count positively correlated with circulating resistin concentration (r = 0.47, P = 0.02).
Hyperresistinemia is a feature of acute pyelonephritis during pregnancy. The results of this study support the role of resistin as an acute-phase protein in the presence of bacterial infection during pregnancy.
抵抗素最初被描述为一种脂肪细胞因子，现已成为一种与急性和慢性炎症相关的强效促炎蛋白。此外，抵抗素已被提出作为严重脓毒症的有力标志物，以及预测重症非孕妇患者存活的指标。本研究旨在确定妊娠期间肾盂肾炎是否与母体血浆抵抗素浓度的变化有关。
这项横断面研究包括以下组别：（i）正常孕妇（n=85）和（ii）患有肾盂肾炎的孕妇（n=40）。通过 ELISA 测定母体血浆抵抗素浓度。采用非参数统计进行分析。
（i）肾盂肾炎患者的母体血浆抵抗素浓度中位数高于正常妊娠患者（P<0.001）；（ii）在患有肾盂肾炎的患者中，血培养阳性和阴性患者的母体抵抗素浓度中位数无显著差异（P=0.3）；（iii）在被诊断为全身炎症反应综合征（SIRS）的肾盂肾炎患者中，符合 SIRS 标准>或=3 项的患者的母体血浆抵抗素浓度中位数明显高于仅符合两项标准的患者；（iv）母体白细胞计数与循环抵抗素浓度呈正相关（r=0.47，P=0.02）。
妊娠期间急性肾盂肾炎的特征是高抵抗素血症。本研究结果支持抵抗素作为急性相蛋白在妊娠期间细菌感染时的作用。
