测量早产孕妇宫颈阴道液中白细胞介素-8 和基质金属蛋白酶-9：与羊水的直接比较。
Measurements of Interleukin-8 and Matrix Metalloproteinases-9 in Cervicovaginal Fluid in Women with Preterm Labor: A Direct Comparison with Amniotic Fluid.
机构信息
Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
出版信息
Am J Perinatol. 2024 May;41(7):867-875. doi: 10.1055/s-0042-1748153. Epub 2022 May 11.
OBJECTIVE
We aimed to evaluate the correlation and agreement of interleukin (IL)-8 and matrix metalloproteinases (MMP-9) levels between cervicovaginal (CVF) and amniotic fluids (AF) in women with preterm labor (PTL) and to determine the clinical values of these proteins in CVF compared with those in AF.
STUDY DESIGN
We designed a retrospective cohort study of 85 singleton pregnant women with PTL at 23 to 34 weeks, who underwent amniocentesis. The AF was cultured, and CVF samples were collected at the time of amniocentesis. Paired AF and CVF samples were assayed for IL-8 and MMP-9 by enzyme-linked immunoassay (ELISA) in duplicate on a single plate, using similar dilution ratios.
RESULTS
A significant but weak correlation was found for IL-8 levels between AF and CVF (r = 0.333), while no correlation was found for MMP-9 levels between AF and CVF (r = -0.039). Intra-class correlation coefficient for the agreement of IL-8 levels between CVF and AF was 0.4335 and -0.279 for MMP-9, indicating a poor-to-fair level of agreement between the two measured values, respectively. IL-8 and MMP-9 levels in CVF were not associated with the risk of either microbial invasion of the amniotic cavity (MIAC) or spontaneous preterm delivery (SPTD) within 7 days, whereas those in AF provided good-to-excellent predictive values for these two outcomes (area under the curve [AUCs]: 0.82-0.95). AUCs for IL-8 and MMP-9 were significantly larger using AF rather than using CVF for the prediction of MIAC and SPTD.
CONCLUSION
In women with PTL, IL-8 and MMP-9 levels in CVF do not precisely reflect the levels of the corresponding proteins in AF. IL-8 and MMP-9 levels in CVF had poor predictive values for the risk of MIAC and SPTD and were significantly inferior to those in AF.
KEY POINTS
· IL-8 and MMP-9 levels in CVF do not precisely reflect levels of the corresponding proteins in AF.. · Diagnostic accuracy of IL-8 and MMP-9 in CVF alone is not sufficient to predict MIAC and SPTD.. · IL-8 and MMP-9 levels in AF provide good-to-excellent predictive values for these two outcomes..
目的
评估早产孕妇宫颈阴道（CVF）和羊水（AF）中白细胞介素（IL）-8 和基质金属蛋白酶（MMP）-9 水平的相关性和一致性，并比较这些蛋白在 CVF 中的临床价值与在 AF 中的价值。
研究设计
本研究为回顾性队列研究，纳入了 85 例 23-34 周的早产单胎孕妇，进行了羊膜穿刺术。培养 AF，并在羊膜穿刺术时采集 CVF 样本。使用类似的稀释比，通过酶联免疫吸附试验（ELISA）在同一板上重复检测配对的 AF 和 CVF 样本中的 IL-8 和 MMP-9。
结果
AF 与 CVF 中 IL-8 水平存在显著但较弱的相关性（r=0.333），而 AF 与 CVF 中 MMP-9 水平无相关性（r=-0.039）。CVF 与 AF 中 IL-8 水平的一致性的组内相关系数为 0.4335，MMP-9 为-0.279，表明这两个测量值的一致性为差到中等水平。CVF 中的 IL-8 和 MMP-9 水平与 7 天内微生物侵袭羊膜腔（MIAC）或自发性早产（SPTD）的风险均无相关性，而 AF 中的 IL-8 和 MMP-9 水平对这两种结局具有良好到极好的预测值（曲线下面积 [AUC]：0.82-0.95）。使用 AF 而非 CVF 预测 MIAC 和 SPTD 时，IL-8 和 MMP-9 的 AUC 显著更大。
结论
在早产孕妇中，CVF 中的 IL-8 和 MMP-9 水平不能准确反映 AF 中相应蛋白的水平。CVF 中的 IL-8 和 MMP-9 水平对 MIAC 和 SPTD 风险的预测价值较差，明显低于 AF 中的水平。
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