Kolben M, Fischbach F, Hofmeister H, Pache L, Graeff H
Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technischen Universität München.
Geburtshilfe Frauenheilkd. 1993 Feb;53(2):81-5. doi: 10.1055/s-2007-1023642.
The aetiology of preterm rupture of membranes is not yet completely understood. Local infections of the vagina and cervix have attracted special attention during the last years. Ascending infection with subsequent chorioamnionitis is a common complication of preterm rupture of membranes. Recognition of the beginning of a chorioamnionitis is usually based on clinical symptoms and laboratory findings like white blood cell count and C-reactive protein. The purpose of this study was to find out the diagnostic value of elastase, a protease of polymorphonuclear granulocytes, which is known to be involved in inflammatory processes. Fifteen out of thirty-three patients with preterm rupture of membranes developed a chorioamnionitis. Elastase plasma concentration levels > or = 32 ng/ml one day before delivery showed a significant correlation (p = 0.02) to the development of a chorioamnionitis. At this time neither white blood cell count, nor rectal body temperature showed significant correlations. Low elastase levels do not exclude an infection, whereas high levels indicate an infectious process. We conclude that elastase is a relevant marker of chorioamnionitis.
胎膜早破的病因尚未完全明确。在过去几年中，阴道和宫颈的局部感染受到了特别关注。上行感染继发绒毛膜羊膜炎是胎膜早破的常见并发症。绒毛膜羊膜炎开始的识别通常基于临床症状和实验室检查结果，如白细胞计数和C反应蛋白。本研究的目的是找出弹性蛋白酶（一种已知参与炎症过程的多形核粒细胞蛋白酶）的诊断价值。33例胎膜早破患者中有15例发生了绒毛膜羊膜炎。分娩前一天血浆弹性蛋白酶浓度水平≥32 ng/ml与绒毛膜羊膜炎的发生呈显著相关性（p = 0.02）。此时，白细胞计数和直肠体温均未显示出显著相关性。低弹性蛋白酶水平不能排除感染，而高弹性蛋白酶水平则表明存在感染过程。我们得出结论，弹性蛋白酶是绒毛膜羊膜炎的一个相关标志物。
