Department of Obstetrics and Gynecology, Magee Womens Hospital, Pittsburgh, PA 15213, USA.
Am J Obstet Gynecol. 2010 Aug;203(2):126.e1-5. doi: 10.1016/j.ajog.2010.03.013. Epub 2010 May 8.
The purpose of this study was to explore the relation between the relative balance of pro- and antiinflammatory cytokines in cervical fluid and mid-trimester cervical length.
In this prospective longitudinal cohort of women with a previous spontaneous preterm birth, mid-trimester cervical length ultrasound scans and cervical fluid levels were obtained serially. Multiple pro- and antiinflammatory cytokines were selected. We summed the multiples of the median for proinflammatory cytokines to generate the proinflammatory and the antiinflammatory scores. The relation between cervical length and pro-/antiinflammatory ratio was assessed by generalized estimating equations.
The pro-/antiinflammatory ratio had a negative linear association with cervical length (beta = -0.09; P < .001). Sixty percent of visits demonstrated greater concentrations of proinflammatory cytokines relative to antiinflammatory cytokines. This relationship did not change between first and last visits.
Among women with a previous preterm birth, shorter mid-trimester cervical length is associated with a more proinflammatory balance of cytokines in the cervical inflammatory milieu.
本研究旨在探讨宫颈液中促炎和抗炎细胞因子的相对平衡与中孕期宫颈长度之间的关系。
本前瞻性纵向队列研究纳入了既往有自发性早产史的女性，对其进行了中孕期宫颈长度超声扫描和宫颈液水平的连续检测。选择了多种促炎和抗炎细胞因子。我们将促炎细胞因子的中位数倍数相加，以生成促炎和抗炎评分。通过广义估计方程评估宫颈长度与促炎/抗炎比值之间的关系。
促炎/抗炎比值与宫颈长度呈负线性关系（β=-0.09；P<.001）。60%的就诊时显示促炎细胞因子的浓度相对高于抗炎细胞因子。这种关系在首次和末次就诊时没有变化。
在既往有早产史的女性中，中孕期宫颈长度较短与宫颈炎症环境中促炎细胞因子的平衡更为明显相关。
