未足月胎膜早破相关机制的研究进展

摘要/Abstract

摘要： 胎膜早破（premature rupture of membranes，PROM）是一种危害孕妇及胎儿健康的产科常见疾病。胎膜早破常分为足月胎膜早破和未足月胎膜早破（preterm premature rupture of membranes， pPROM）。pPROM的影响因素众多，发生机制目前尚不明确。本研究拟综合pPROM相关资料，总结分析pPROM发生的相关机制。研究显示PROM与凝血酶原相关，凝血酶原可以直接由胎膜羊膜、绒毛膜和蜕膜细胞产生以及胎膜中暴露的小量尿素也可刺激凝血酶原的产生；氧化应激反应导致胎膜薄弱，从而导致PROM；前B细胞集落增强因子（pre-B-cell colony-enhancing factor， PBEF）受到刺激，则导致提前分娩，可作为羊水渗漏的通道，也可作为炎症细胞和微生物迁移通道的妊娠期胎膜中的微裂缝有可能是组织重塑的部位。

Abstract: Premature rupture of membranes (PROM) is a common obstetric disease that jeopardizes the health of pregnant women and their fetuses. PROM is often divided into term premature rupture of membranes (tPROM) and preterm premature rupture of membranes (pPROM). There are many factors influencing pPROM， and the mechanism of occurrence is still unclear. In this study， we intend to summarize relevant data of pPROM， and analyze the relevant mechanisms of pPROM. The results show PROM is related to prothrombin. Prothrombin can be produced directly from the cells on the amnion， chorion and decidua， and its generation can also be stimulated by a small amount of urea exposed to fetal membrane. In addition， oxidative stress reaction causes fetal membrane to be very weak， leading to PROM. Pre-B cell colony-enhancing factors are stimulated， leading to early delivery. Micro-cracks in the fetal membrane during pregnancy can be used as a channel for leakage of amniotic fluid and a channel for inflammatory cells and microbial (bacteria) transport， and may be a site for tissue remodeling.

林晓妍,易媛媛. 未足月胎膜早破相关机制的研究进展[J]. .

Lin Xiaoyan and Yi Yuanyuan. Research Progress on the Mechanism of Preterm Premature Rupture of Membranes[J]. .

参考文献

Lorthe E.Tocolysis after preterm premature rupture of membranes and neonatal outcome: a propensity- score analysis[ J] . American Journal of Obstetrics & Gynecology, 2018 , 217 ( 2 ) :-.
2. 张霞晖,陈一婉,龙晓茜,等．血清 β－绒毛膜促性腺激素与Ｃ－反应蛋白水平在预测胎膜早破宫内感染及预后评价分析 [Ｊ]．中华医院感染学杂志,2017,27(5)：1167－1170．
刘騱遥.美国妇产科医师学会“胎膜早破指南2018版”解读[J].中国实用妇科与产科杂志,2018,34(3):266-269.
4.Preterm premature rupture of membranes at 22-25 weeks’ gestation: perinatal and 2-year outcomes within a national population-based study (EPIPAGE-2)[J]. American Journal of Obstetrics Gynecology, 2018.
Goldenberg Robert L, Culhane Jennifer F, Iams Jay D, Romero Roberto.Epidemiology and causes of preterm birth[ J] . Lancet, 2008 , 371 ( 9606 ) : 75 - 84 .
6.Julien M , N''Guema L , Bouzerara A , et al. Premature rupture of the membranes: analytical evaluation of diagnostic tests.[J]. Ann Biol Clin, 2018:300-306.
7.Zhang C , Wang W , Liu C , et al. Role of NF-κB/GATA3 in the inhibition of lysyl oxidase by IL-1β in human amnion fibroblasts[J]. Immunology Cell Biology, 2017, 95(10):943.
8.吴红莲, 陈艳, 黄志华,等. 胎膜早破孕妇血清白细胞介素-6和C-反应蛋白的变化情况与胎膜早破感染的关系[J]. 中华医院感染学杂志, 2018(7).
9.王楠, 何亚萍, 王健. 蜕膜巨噬细胞在母胎界面调控机制的研究进展[J]. 生殖医学杂志, 2017, 26(9):946-950.
Farine T.Isolation of Primary Human Decidual Cells from the Fetal Membranes of Term Placentae[ J] . J Vis Exp, 2018,2018 ( 134 ) :-.
11.王笑盈, 王晓迪. 胎膜早破孕产妇感染的危险因素分析[J]. 中国卫生检验杂志, 2018(6).
Lucas G. Gimenez.Maternal and neonatal epidemiological features in clinical subtypes of preterm- birth[ J] . J Matern Fetal Neonatal Med, 2016 , 29 ( 19 ) : 3153 - 3161 .
13.Qimei Z , Lan W , Zhen C , et al. Analysis on clinical risk factors for histological chorioamnionitis occurrence after premature rupture of membranes in pregnant women[J]. Chongqing Medicine, 2018.
14.Assefa NE , Berhe H , Girma F , Berhe K , Berhe YZ , Gebreheat G , Werid WM , Berhe A , Rufae HB , Welu G . Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study.BMC Pregnancy Childbirth 2018 Sep;18 (1): 386.
Deepak Kumar.The physiology of fetal membrane weakening and rupture: Insights gained from the determination of physical properties revisited[ J] . Placenta, 2016 , 42 ( 12 ) : 59 - 73 .
16.Suna N I, Liu J. Expressions of MMPs,TIMPs and TLR in the fetal membrane tissues of patients with PROM[J]. Hebei Medical Journal, 2018.
17.Ding Q, Wang C, Chen W, et al. Clinical significance of IGFBP-1,MMP-9 and HCG in the diagnosis of premature rupture of membranes[J]. Laboratory Medicine Clinic, 2018.
18.TIAN Ling, WAN Min, WANG Qian, et al. Role of matrix metalloproteinases-9,collagen Ⅲ and fibronectin in premature rupture of fetal membranes[J]. Journal of Bengbu Medical College, 2018.
Feng L.Infection- Induced Thrombin Production: A Potential Novel Mechanism for Preterm Premature Rupture of Membranes ( PPROM) [ J] . American Journal of Obstetrics & Gynecology, 2018 , 219 ( 1 ) :-.
20.Puthiyachirakkal M, Lemerand K, Kumar D, et al. Thrombin weakens the amnion extracellular matrix (ECM) directly rather than through protease activated receptors. Placenta.
2013;34(10):924–931.
21.Murtha AP, Menon R. Regulation of fetal membrane in?am- mation: a critical step in reducing adverse pregnancy out- come. Am J Obstet Gynecol. 2015;213(4):447–448.
22.云博, 吴景东. 氧化应激与相关疾病及其作用机制[J]. 沈阳医学院学报, 2018(3).
23.郑义鹏, 魏学敏, 周庆彪,等. 线粒体分裂融合与细胞氧化还原交互调控作用的研究进展[J]. 癌变.畸变.突变, 2018, 30(3).
24. 汪莲, 谢敏, 况菊. NALP3炎性复合体及p38MAPK信号通路在氧化应激中的作用及阿魏酸钠的干预机制[J]. 四川大学学报(医学版), 2018(2).
25.Richardson L S, Vargas G, Brown T, et al. Discovery and Characterization of Human Amniochorionic Membrane Microfractures[J]. American Journal of Pathology, 2017, 187(12).#$NL26.Mrcog S R M M, Mrcog S J S M, Mrcog S C, et al. Spontaneous preterm birth prevention in multipleSpregnancy[J]. Obstetrician Gynaecologist, 2018, 20(1):57-63.
27.Pavlová T, Zlámal F, ?plíchal Z, et al. Umbilical Cord Blood and Maternal Visfatin (PBEF/Nampt) Concentrations in Preterm Birth with and without Preterm Premature Rupture of Membranes.[J]. The journal of maternal-fetal neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2017, 31(14):1.19.
28.姜文英, 吴雅枫, 卓广超,等. 内脂素、多项血清因子预测宫内感染的意义[J]. 中国妇幼健康研究, 2014(2).
29.Kendalwright C E. Stretching, mechanotransduction, and proinflammatory cytokines in the fetal membranes.[J]. Reproductive Sciences, 2007, 14(8 Suppl):35.

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