Kacerovsky Marian, Andrys Ctirad, Hornychova Helena, Pliskova Lenka, Lancz Kinga, Musilova Ivana, Drahosova Marcela, Bolehovska Radka, Tambor Vojtech, Jacobsson Bo
Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
J Matern Fetal Neonatal Med. 2012 Jul;25(7):1148-55. doi: 10.3109/14767058.2011.626821. Epub 2011 Oct 31.
To determine amniotic fluid soluble Toll-like receptor 4 (sTLR4) levels in women with preterm prelabor rupture of the membranes according to the presence of microbial invasion of the amniotic cavity and histological chorioamnionitis and its relation to neonatal outcome.
One hundred two women with singleton pregnancies with a gestational age between 24 + 0 and 36 + 6 weeks were included in a prospective cohort study. Amniocenteses were performed, and the concentrations of sTLR4 in the amniotic fluid were determined using sandwich enzyme-linked immunosorbent assay technique.
Women with the presence of microbial invasion of the amniotic cavity had higher sTLR4 levels [median 54.2 ng/mL, interquartile range (IQR) 10.15-289.9] than those without this condition (median 18.1 ng/mL, IQR 8.1-29.9; p = 0.001). Women with the presence of histological chorioamnionitis had a higher sTLR4 level (median 28.0 ng/mL, IQR 11.15-178.1) compared with women without histological chorioamnionitis (median 13.0 ng/mL, IQR 7.8-28.7; p = 0.003). A mixed linear model was used to adjust for confounders. The difference was found only between women with and without microbial invasion of the amniotic cavity in this model.
Microbial invasion of the amniotic cavity was associated with higher amniotic fluid sTLR4 levels independent of confounders.
根据羊膜腔微生物入侵及组织学绒毛膜羊膜炎的情况，测定胎膜早破早产女性羊水中可溶性Toll样受体4（sTLR4）水平，并探讨其与新生儿结局的关系。
102例单胎妊娠、孕周在24 + 0至36 + 6周之间的女性纳入前瞻性队列研究。进行羊膜腔穿刺，并采用夹心酶联免疫吸附测定技术测定羊水中sTLR4的浓度。
存在羊膜腔微生物入侵的女性sTLR4水平[中位数54.2 ng/mL，四分位数间距（IQR）10.15 - 289.9]高于无此情况的女性（中位数18.1 ng/mL，IQR 8.1 - 29.9；p = 0.001）。存在组织学绒毛膜羊膜炎的女性sTLR4水平（中位数28.0 ng/mL，IQR 11.15 - 178.1）高于无组织学绒毛膜羊膜炎的女性（中位数13.0 ng/mL，IQR 7.8 - 28.7；p = 0.003）。采用混合线性模型对混杂因素进行校正。在此模型中，仅在有和没有羊膜腔微生物入侵的女性之间发现了差异。
羊膜腔微生物入侵与较高的羊水sTLR4水平相关，且不受混杂因素影响。
