sRAGE在围产期孕妇血清的表达水平变化特点及其在早产中的预测价值

赵爱

摘要: 目的探讨血清可溶性晚期糖基化终产物（sRAGE）分别在先兆早产、未足月胎膜早破、足月胎膜早破患者中的水平变化，及其对母儿预后的价值。方法选取2017年1-7月在徐州医科大学附属医院产科诊治的先兆早产孕妇（A组）32例，未足月胎膜早破孕妇（B组）36例，足月胎膜早破组孕妇（D组）34例。同时选取同期在本院正常产检并最终分娩的健康孕妇为对照组，其中孕28-36+6 周作为C组36例，孕37-41周作为E组。采用ELISA法检测各组中血清sRAGE水平。所有纳入研究的产妇还需测定其静脉血中CRP、WBC、中性粒细胞百分比、中性粒细胞计数。分析血清sRAGE水平在不同孕周的变化与血白细胞计数、C-反应蛋白、中性粒细胞百分比、中性粒细胞计数、并记录从出现症状（不规律宫缩或胎膜破裂）到分娩的时间、胎龄以及新生儿出生时的体重的相关性。结果（1）先兆早产组、未足月胎膜早破组及相应孕周正常待产组三组孕妇血清sRAGE浓度分别为64.61±7.14pg/ml、14.82±2.83pg/ml、67.78±6.45pg/ml,三者差异有统计学意义（p<0.05），且胎膜早破组较其他两组血清sRAGR浓度明显降低，先兆早产症状的孕妇比相应孕周正常待产组的孕妇其血清sRAGE浓度水平要高。（2）足月胎膜早破组血清sRAGE(pg/ml)均值为62.72，足月正常待产组血清sRAGE(pg/ml)均值为66.75，足月正常待产组均值高足月胎膜早破组，差异有统计学意义(P=0.033＜0.05)。（3）先兆早产组孕妇血清中sRAGE与出现先兆早产症状至分娩的潜伏期（r=0.458、P=0.025）呈正相关；未足月胎膜早破组孕妇血清中sRAGE与发生胎膜破裂至分娩的潜伏期（r=0.605、P＜0.01）呈正相关。结论 sRAGE可以作为预测早产预后的一有利因素，高浓度的sRAGE可反映母儿一定的良好预后。

Abstract: Objective To investigate the levels of serum soluble advanced glycation end products (sRAGE) in threatened preterm labor, preterm premature rupture of membranes, and preterm premature rupture of membranes, and its prognostic value in Mother and fetus.Methods From January to July 2017,we recruited 32 pregnant women (A)with threatened preterm labor, 36 pregnant women (B)with preterm premature rupture of membranes and 34 pregnant women (D)with preterm premature rupture of membranes who received treatment in obstetrics hospital of Xuzhou Medical University were recruited in the study.The healthy pregnant women who had been examined and delivered in the same period were selected as the control group, of which in 28-36+6 weeks pregnant as C group and 37-41 weeks pregnant as E group, group.We used ELISA to detect serum sRAGE levels in each group.The CRP, WBC, neutrophil percentage and neutrophil count in the venous blood were also measured in all the women enrolled in the study.The relationship between these and classic intrauterine infection markers and the latent time from symptoms up to delivery depending on RAGE’s concentration were investigated. Results (1)The serum levels of sRAGE in the severe preeclampsia group were 64.61±7.14pg/ml、14.82±2.83pg/ml、67.78±6.45pg/ml,The difference between the three groups was statistically significant(p<0.05).(2)The normal pregnant group and premature rupture of membranes difference of serum level of sRAGE group was statistically significant(P=0.033＜0.05).(3)There is a certain correlation between serum sRAGE concentration and the time（r=0.458、P=0.025;r=0.605、P＜0.01）. Conclusion sRAGE can be a favorable predictor of the prognosis of preterm labor. High levels of sRAGE may reflect a favorable prognosis for both mothers and infants