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만삭 전 조기양막파열 임부에서 항생제 투여 후 정맥혈장 내 지질과산화도와 단백산화도의 변화

Changes in lipid peroxidation and protein oxidation by antibiotic therapy in the maternal venous plasma of preterm premature rupture of membranes

송태복|안봉환|양성렬|김석모|김철홍|조문경|강우대|조혜연|김윤하|김종운|하진아
대한산부인과학회 (Korean Soceity of Obstetrics and Gynecology)|2009.07|Obstetrics & Gynecology Science|제52권 제7호|pp. 707-716

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키워드

지질과산화물Lipid peroxide만삭 전 조기양막파열임부 정맥혈장단백산화촉진능Preterm premature rupture of membraneMaternal serum plasmProoxidative stimulating activity
주제분류산부인과학

초록

목적: 만삭 전 조기양막파열 임부에게 항생제를 투여한 후 정맥혈장 내 지질과산화도와 단백산화도를 비교분석하여 이들이 어떤 영향을 미치는 가에 대하여 규명하고자 한다. 연구 방법: 임신 25주 이상 32주 미만의 만삭 전 조기양막파열 임부 36명 중 1군 18명은 amoxacillin계와 erythromycin계 항생제를 7일간 병합 투여하고, 2군 18명은 3세대 cephalosporin계 (cefodizime, cefditoren)와 erythromycin계 항생제를 7일간 병합 투여하였다. 각 군에서 투여 전, 3일째, 7일째 팔오금 중간정맥혈을 채취하고 원심분리 후 혈장을 얻었다. Thiobarbituric acid 반응을 이용하여 지질과산화물 농도를 측정하였고, 2,4-dinitrophenylhydrazine 방법을 이용하여 단백질의 carbonyl기 함량을 측정하였다. 대조군으로 임신 25주 이상 32주 미만 정상임부 18명의 정맥혈장을 얻어 시험관 내 방법으로 지질과산화물 농도와 단백질의 carbonyl기 함량을 측정하였다. Interleukin (IL)-6은 enzyme-linked immunosorbent assay kit를 이용하여 측정하였다. 결과: 1. 만삭 전 조기양막파열 임부군 (18명)의 정맥혈장 내 지질과산화물 농도와 단백질의 carbonyl기 함량은 4.77±0.36, 7.11±0.41 nmol/mg protein으로, 정상임부군 (18명) 3.55±0.22, 5.69±0.30 nmol/mg protein보다 모두 유의하게 높았다 (P<0.01). 2. 만삭 전 조기양막파열 임부군 (18명)의 정맥혈장에서 시험관 내 방법으로 amoxacillin계, 3세대 cephalosporin계 및 erythromycin계 항생제를 처치한 전과 후에 측정한 지질과산화물 농도와 단백질의 carbonyl기 함량의 차이는 의의가 없었다. 3. 1군의 투여 전, 투여 3일째, 7일째 정맥혈장 내 지질과산화물 농도는 4.51±0.41, 4.33±0.28, 4.55±0.35 nmol/mg protein이며, 2군의 투여 전, 투여 3일째, 7일째 정맥혈장 내 지질과산화물 농도는 4.89±0.22, 4.62±0.21, 4.50±0.26 nmol/mg protein으로 유의한 차이는 없었다. 4. 1군의 투여 전, 투여 3일째, 7일째 정맥혈장 내 단백질의 carbonyl기 함량은 7.21±0.38, 7.53±0.41, 7.70±0.54 nmol/mg protein으로 유의한 차이는 없었다. 그러나 2군의 투여 전, 투여 3일째, 7일째 정맥혈장 내 단백질의 carbonyl기 함량은 7.04±0.51, 6.04±0.44, 5.53±0.37 nmol/mg protein으로 투여 전보다 투여 7일째가 유의하게 감소하였다 (P<0.05). 5. 1군의 투여 전과 7일째 정맥혈장 내 IL-6 농도는 6.82±0.38, 8.21±0.54 pg/mL으로 유의한 차이는 없었다. 2군의 투여 전과 7일째 정맥혈장 내 IL-6농도는 7.50±0.35, 3.13±0.37 pg/mL으로 유의하게 감소하였다 (P<0.05). 결론: 만삭 전 조기양막파열 시 정맥혈장에서 지질과산화와 단백질의 산화적 변화가 증가되어 있었으며, 3세대 cephalosporin계와 erythromycin계 병합치료에 의해 단백질의 산화도와 IL-6 생성이 감소되는 경향을 보였다. 이는 3세대 cephalosporin계와 erythromycin계 병합요법이 염증성 반응으로 발생되는 활성 산소를 억제시키는 효과를 나타낸 것으로 사료된다.

Abstract

Objective: To investigate and compare the amount of the lipid peroxidation and the protein carbonyls formation in maternal venous plasma of preterm premature rupture of membranes (PPROM) during antibiotics administration. Methods: PPROM were selected between 25 and 32 weeks of gestation. Eighteen patients (group 1) were treated with amoxicillin and erythromycin for 7 day period, 18 patients (group 2) were treated with 3rd generation cephalosporin (cefodizime, cefditoren) and erythromycin for the same period. Maternal blood were obtained from the two groups before and after the antibiotics administration, day 3 and day 7. Lipid peroxidation levels and protein carbonyl contents were measured by thiobarbituric acid reaction and 2,4-dinitrophenyl hydrazine method. Other 18 women with normal pregnancy between 25 and 32 weeks of gestation of venous blood were checked same things in vitro. Interleukin (IL) -6 was measured by enzyme-linked immunosorbent assay. Results: 1. The lipid peroxidation levels and protein carbonyls formation in the maternal venous plasma of PPROM was significantly higher than that of normal pregnancy (lipid peroxidation levels; 4.77±0.36 vs 7.11±0.41 nmol/mg protein, P<0.01, protein carbonyls formation; 3.55±0.22 vs 5.69±0.30 nmol/mg protein, P<0.01). 2. There were no significant differences in the lipid peroxidation levels and protein carbonyls formation of the maternal venous plasma with PPROM mixed and incubated by amoxicillin, cefodizime, cefditoren, and erythromycin (in vitro). 3. There were no significant differences in the lipid peroxidation levels and protein carbonyls formation of the venous plasma of group 1 between before and after antibiotics administration, day 3 and day 7. 4. There were no significant differences in the lipid peroxide levels of the venous plasma of group 2 between before and after antibiotics administration, day 3 and day 7. 5. The protein carbonyls formation in the venous plasma of group 2 was significantly decreased at day 3 and day 7 after antibiotics administration than that of before (6.04±0.44 and 5.53±0.37 vs. 7.04±0.51 nmol/mg protein, P<0.05). 6. The levels of IL-6 in the venous plasma of group 2 was significantly decreased at day 7 after antibiotics administration than that of before (7.50±0.35 vs. 3.13±0.37 pg/mL, P<0.05). Conclusion: In the maternal venous plasma of PPROM, the lipid peroxidation levels and protein carbonyls formation were increased. The formation of protein carbonyls and IL-6 in the maternal blood of PPROM was decreased by combined treatment of 3rd generation cephalosporin and erythromycin. The results suggest that reactive oxygen species formation by inflammatory reaction is suppressed by the 3rd generation cephalosporins and erythromycin combined treatment.

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만삭전 조기양막파열 임부에서 정맥혈장내 지질과산화도와 단백산화도의 증가김기민, 김윤하, 김종운, 김철홍, 송태복, 안봉환, 양성렬, 조문경대한산부인과학회 · Obstetrics & Gynecology Science2007 · 제50권 제4호만삭 전 조기양막파열 임부의 정맥혈장과 양수 내 지질과산화 및 항산화능강우대, 김석모, 김윤하, 김종운, 김철홍, 박소정, 송태복, 안봉환, 양성렬, 이광수, 조문경, 조혜연대한산부인과학회 · Obstetrics & Gynecology Science2009 · 제52권 제01호만삭전 조기양막파열 산모의 정맥혈장내 지질과산화,항산화능 및 항산화 비타민치김석모, 김윤하, 김철홍, 송태복, 안봉환, 양성열, 이광수, 조문경대한산부인과학회 · Obstetrics & Gynecology Science2004 · 제47권 제2호조기분만 시 조직학적 융모양막염 유무에 따른 혈청 C-반응성 단백질, 태반 내 interleukin-6, 지질과산화도 및 단백산화도강우대, 김석모, 김윤하, 김종운, 김철홍, 송태복, 윤대석, 이기호, 조문경, 조혜연대한산부인과학회 · Obstetrics & Gynecology Science2011 · 제54권 제1호조기 진통 및 조기 양막 파수 임신부의 자궁경부 분비물 내 Interleukin-6의 임상적 의의김성웅, 박성철, 이두진, 이승호영남대학교 의과대학 · Journal of Yeungnam Medical Science2007 · 제24권 제2호만삭 전자간증 산모의 양수에서 산화 스트레스 표지자인 단백질 카르보닐의 증가김병재, 박중신대한산부인과학회 · Obstetrics & Gynecology Science2007 · 제50권 제10호

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