摘要
目的探讨孕妇血清铜（Cu）、羊膜Cu、羊膜赖氨酰氧化酶（LOX）、羊膜Ⅲ型胶原的水平之间的相关性，以及与胎膜早破的关系。方法100例胎膜早破孕妇作为胎膜早破组，其中妊娠37～42周40例、34～36周^＋6 40例、28～33周^＋6 20例；与胎膜早破组孕周、例数相对应的100例非胎膜早破孕妇作为对照组。应用火焰原子吸收法检测两组孕妇血清Cu和羊膜Cu水平，荧光发光法检测羊膜LOX水平，免疫组化法和图像分析法检测羊膜Ⅲ型胶原水平。将不同孕周孕妇血清Cu、羊膜Cu、羊膜LOX、羊膜Ⅲ型胶原测定结果进行直线相关分析，并比较胎膜早破组与对照组在这些指标上的差异。结果（1）妊娠37—42周：两组孕妇血清Cu与羊膜Cu水平呈正相关，r为0．82（P〈0．001），其他各指标均无相关关系。（2）妊娠34～36周^＋6和28～33周^＋6：两组孕妇血清Cu、羊膜Cu、羊膜LOX、羊膜Ⅲ型胶原水平之间均呈正相关（P〈0．01）。（3）妊娠37～42周：两组孕妇血清Cu水平与羊膜Cu比较，差异无统计学意义（P〉0．05）；胎膜早破组及对照组孕妇羊膜LOX水平分别为（0．53±0．10）和（0．75±0．10）μg／g（P〈0．01），羊膜Ⅲ型胶原吸光度（A）值分别为0．36±0．01和0．37±0．01（P〈0．05）；（4）妊娠34—36周^＋6：胎膜早破组及对照组孕妇血清Cu水平分别为（115．23±9．56）、（139．03±10．59）mg／L，羊膜Cu水平分别为（0．19±0．04）、（0．29±0．04）μg／mg，羊膜LOX水平分别为（0．54±0．10）、（0．70±0．13）μg／g，羊膜Ⅲ型胶原A值分别为0．36±0．01、0．37±0．01。胎膜早破组以上各指标均低于对照组，两组比较，差异有统计学意义（P〈0．01）。（5）妊娠28～33周^＋6：胎膜早破组及对照组孕妇血清Cu水平分别为（120．31±8．04）、（136．40±8．21）μg／L，羊膜Cu水平分别为（0．21±0．04）、（0．26±0．03）μg／mg，羊膜LOX水平分别为（0．62±0．09）、（0．72±0．09）μg／g，羊膜Ⅲ型胶原A值分别为0．35±0．01、0．38±0．01。胎膜早破组以上各指标均低于对照组，两组比较，差异有统计学意义（P〈0．01）。结论足月妊娠的胎膜早破孕妇，其羊膜LOX和羊膜Ⅲ型胶原水平下降不受血清Cu水平的影响，这可能与羊膜的退行性变加快有关；未足月妊娠的胎膜早破孕妇血清Cu、羊膜Cu、羊膜LOX和羊膜Ⅲ型胶原的水平降低则与胎膜早破的发生直接相关。
Objective To determine the relationships between maternal serum copper, amniotic copper, lysyl oxidase （LOX） and collagen Ⅲ in pregnant women with premature rupture of membranes （PROM） and without PROM. Methods One hundred women with PROM were enrolled in this study, and divided into 37 -42 weeks,34 -36^＋6weeks and 28 -33 ^＋6weeks according to gestational age. One hundred non-PROM pregnancies matching the same gestational ages were recruited as control group. Copper of maternal serum and amnion in two groups were compared by FAAS method, Amniotic LOX was analyzed by fluorometry. Amniotic collagen Ⅲ was detected by immunohistochemical method and computer image analysis system（absorbance,A）. Linear correlation analysis was used to explore the relationships between maternal serum copper,amniotic copper, LOX and collagen Ⅲ. Results （1）For 37 -42 weeks pregnant women, serum copper was correlated positively with amniotic copper in two groups, r =0. 82 （ P 〈 0. 001 ）, but for other parameters, the serum and amniotic levels had no correlations. （2） For 34 -36^＋6 and 28 -33 ^＋6 weeks pregnant women, there were positive correlations between serum copper, amniotic copper, LOX and collagen Ⅲ in two groups（P 〈 0. 01 ）. （3） For 37 - 42 weeks pregnant women, serum copper and amniotic copper had no difference between two groups （ P 〉 0. 05 ）, but amniotic LOX and collagen Ⅲ decreased significantly compared with controls, being [ （0. 53 ＋0. 10） μg/g vs （0. 75 ±0. 10） μg/g,P 〈0. 01], （0. 36 ± 0. 01 vs 0. 37 ＋ 0. 01, P 〈 0. 05 ） respectively. （ 4 ） For 34-36^＋6 weeks pregnant women, serum copper, amniotic copper, LOX and collagen Ⅲ reduced obviously between two groups（ P 〈 0. 01 ）, being respectively [ （115.23 ± 9. 56） mg/L vs （ 139. 03 ± 10. 59）mg/L], [ （0. 21 ± 0. 04）μg/mg vs （ 0. 29 ± 0. 04） μg/mg], [（0.54±0. 10）μg/gvs （0.70±0.13）μg/g],and （0.36±0.01 vs0. 37±0. 01）. （5）For28-33^＋6 weeks pregnant women, serum copper,amniotic copper,LOX and collagen IU also reduced obviously between two groups（P 〈 0. 01 ）, [ （ 120. 31 ± 8.04） μg/L vs （ 136. 40 ± 8.21 ） μg/L], [ （0. 21 ± 0. 04）μg/mg vs （0.26±0.03）μg/mg], [（0.62 ±0.09）μg/g vs （0.72 ±0.09）μg/g],and （0.35 ±0.01 vs 0.38 ± 0. 01 ）. Conclusion For term pregnant women, the decreases of amniotic LOX and collagen Ⅲ in PROM group are not affected by serum copper,perhaps by excessive degeneration of amnion;for non-term pregnant women,the decreases of serum copper, amniotic copper, LOX and collagen Ⅲ are correlated directly with PROM.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2006年第1期7-11,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
胎膜早破
铜
蛋白赖氨酸6-氧化酶
胶原Ⅲ型
Fetal membranes, premature rupture
Copper
Protein-lysine 6-oxidase
Collagen type Ⅲ
