羊膜腔内感染和无菌性羊膜腔内炎症与胎膜完整的自发性早产女性宫颈液中白细胞介素-6浓度升高有关。
Intra-amniotic infection and sterile intra-amniotic inflammation are associated with elevated concentrations of cervical fluid interleukin-6 in women with spontaneous preterm labor with intact membranes.
作者信息
Stranik Jaroslav, Kacerovsky Marian, Andrys Ctirad, Soucek Ondrej, Bolehovska Radka, Holeckova Magdalena, Matulova Jana, Jacobsson Bo, Musilova Ivana
机构信息
Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
出版信息
J Matern Fetal Neonatal Med. 2022 Dec;35(25):4861-4869. doi: 10.1080/14767058.2020.1869932. Epub 2021 Jan 7.
OBJECTIVE
To determine the concentration of interleukin-6 (IL-6) in the cervical fluid in women with spontaneous preterm labor with intact fetal membranes (PTL) complicated by intra-amniotic infection (the presence of both microbial invasion of the amniotic cavity and intra-amniotic inflammation), or sterile intra-amniotic inflammation (the presence of intra-amniotic inflammation alone).
METHODS
Eighty women with singleton pregnancies complicated by PTL between gestational ages 22 + 0 and 34 + 6 weeks were included in this retrospective cohort study. Samples of amniotic and cervical fluids were collected at the time of admission. Amniotic fluid samples were obtained via transabdominal amniocentesis, and cervical fluid was obtained using a Dacron polyester swab. Microbial invasion of the amniotic cavity was diagnosed based on the combination of culture and molecular biology methods. The concentration of IL-6 in the amniotic and cervical fluids were measured using an automated electrochemiluminescence immunoassay method. Intra-amniotic inflammation was defined as an amniotic fluid IL-6 concentration ≥3000 pg/mL.
RESULTS
The presence of intra-amniotic infection and sterile inflammation was identified in 15% (12/80) and 26% (21/80) of the women, respectively. Women with intra-amniotic infection (median: 587 pg/mL; = .01) and with sterile intra-amniotic inflammation (median: 590 pg/mL; = .005) had higher concentrations of IL-6 in the cervical fluid than those without intra-amniotic inflammation (intra-amniotic infection: median 587 pg/mL vs. without inflammation, median: 136 pg/mL; = .01; sterile intra-amniotic inflammation, median: 590 pg/mL vs. without inflammation, = .005). No differences were found in the concentrations of IL-6 in the cervical fluid between women with intra-amniotic infection and sterile intra-amniotic inflammation ( = .81).
CONCLUSION
In pregnancies with PTL, both forms of intra-amniotic inflammation are associated with elevated concentrations of IL-6 in the cervical fluid.
目的
确定胎膜完整的自发性早产（PTL）且合并羊膜腔感染（同时存在羊膜腔微生物入侵和羊膜腔内炎症）或无菌性羊膜腔内炎症（仅存在羊膜腔内炎症）的女性宫颈液中白细胞介素-6（IL-6）的浓度。
方法
本回顾性队列研究纳入了80例单胎妊娠且孕周在22⁺⁰至34⁺⁶周之间并发PTL的女性。入院时采集羊水和宫颈液样本。羊水样本通过经腹羊膜腔穿刺获取，宫颈液样本使用涤纶聚酯拭子采集。基于培养和分子生物学方法相结合诊断羊膜腔微生物入侵。采用自动电化学发光免疫分析方法测定羊水和宫颈液中IL-6的浓度。羊膜腔内炎症定义为羊水IL-6浓度≥3000 pg/mL。
结果
分别在15%（12/80）和26%（21/80）的女性中发现存在羊膜腔感染和无菌性炎症。合并羊膜腔感染（中位数：587 pg/mL；P = 0.01）和无菌性羊膜腔内炎症（中位数：590 pg/mL；P = 0.005）的女性宫颈液中IL-6浓度高于无羊膜腔内炎症的女性（羊膜腔感染：中位数587 pg/mL vs. 无炎症，中位数：136 pg/mL；P = 0.01；无菌性羊膜腔内炎症，中位数：590 pg/mL vs. 无炎症，P = 0.005）。合并羊膜腔感染和无菌性羊膜腔内炎症的女性宫颈液中IL-6浓度无差异（P = 0.81）。
结论
在PTL妊娠中，两种形式的羊膜腔内炎症均与宫颈液中IL-6浓度升高有关。
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