Boggess K A, Greig P C, Murtha A P, Jimmerson C E, Herbert W N
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA.
J Reprod Immunol. 1997 Apr;33(1):45-52. doi: 10.1016/s0165-0378(97)01011-5.
Preterm birth has been linked with intrauterine infection and inflammation. Serum and amniotic fluid markers of inflammation, such as interleukin-1 (IL-1), IL-6, and granulocyte-colony stimulating factor (G-CSF), have been associated with clinical chorioamnionitis and preterm delivery. As G-CSF regulates the production and maturation of neutrophils, we sought to determine if maternal serum G-CSF levels are elevated in patients with preterm birth with subclinical histologic chorioamnionitis. Maternal serum G-CSF levels were significantly different among five groups of women studied (P < .001, Kruskall-Wallis test), and were highest in subjects with preterm labor who delivered preterm (P < .05, Mann-Whitney U test). Among women with preterm labor who delivered preterm, maternal serum G-CSF levels were significantly higher if histologic chorioamnionitis was present than when histologic evidence of infection was not present (P = 0.04, Mann-Whitney U test). Intrauterine infection may cause a local inflammatory process and initiate preterm labor. This inflammatory response may include production of G-CSF, which would enter the circulation and stimulate the migration of neutrophils to the site of infection. Our data support this concept, as maternal serum G-CSF is elevated with subclinical infection in association with preterm birth.
早产与宫内感染及炎症有关。炎症的血清和羊水标志物，如白细胞介素-1（IL-1）、IL-6和粒细胞集落刺激因子（G-CSF），与临床绒毛膜羊膜炎及早产相关。由于G-CSF调节中性粒细胞的产生和成熟，我们试图确定早产合并亚临床组织学绒毛膜羊膜炎患者的母体血清G-CSF水平是否升高。在研究的五组女性中，母体血清G-CSF水平存在显著差异（P < 0.001，Kruskal-Wallis检验），且在早产的早产临产患者中最高（P < 0.05，Mann-Whitney U检验）。在早产的早产临产女性中，存在组织学绒毛膜羊膜炎的患者母体血清G-CSF水平显著高于不存在感染组织学证据的患者（P = 0.04，Mann-Whitney U检验）。宫内感染可能引发局部炎症过程并启动早产临产。这种炎症反应可能包括G-CSF的产生，其会进入循环并刺激中性粒细胞迁移至感染部位。我们的数据支持这一概念，因为早产合并亚临床感染时母体血清G-CSF会升高。
