만삭 전 조기양막파열 임부의 정맥혈장과 양수 내 지질과산화 및 항산화능
Lipid peroxidation and total antioxidant ability in venous plasma and amniotic fluid of pregnant women with preterm premature rupture of membranes
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목적: 만삭 전 조기양막파열 임부의 정맥혈장과 양수 내 염증성 cytokine, 지질과산화물, 항산화능 및 항산화제의 변화를 측정하고 이들을 정상 임부의 것과 비교분석하여 만삭 전 조기양막파열 병태생리에 어떤 역할을 하는가 규명하고자 하였다. 연구 방법: 임신 25주 이상 37주 미만의 정상 임부 20명과 만삭 전 조기양막파열 임부 20명으로부터 상완정맥혈을 채취하여 혈장을 얻고 양수천자를 하여 양수를 얻었다. Enzyme-linked immunosorbent assay kit을 이용하여 interleukin (IL)-6 농도를 측정하였다. Thiobarbituric acid 반응을 이용하여 지질과산화물 농도, Cao의 방법으로 항산화능을 측정하고, high performance liquid chromatography를 이용하여 항산화 성분들을 측정하였다. 결과: 1. 혈장과 양수 내 IL-6 농도는 정상 임부군보다 만삭 전 조기양막파열군의 혈장과 양수에서 모두 유의하게 증가하였다 (P<0.01)(P<0.01). 2. 혈장과 양수 내 지질과산화물 농도는 정상 임부군보다 만삭 전 조기양막파열군의 혈장과 양수에서 모두 유의하게 증가하였다 (P<0.01)(P<0.01). 3. 혈장과 양수 내 항산화능 값은 정상 임부군보다 만삭 전 조기양막파열군의 혈장과 양수에서 모두 유의하게 감소하였다 (P<0.01)(P<0.01). 4. 혈장과 양수 내 항산화능 값/지질과산화 농도의 비는 정상 임부군보다 만삭 전 조기양막파열군의 혈장과 양수에서 모두 유의하게 감소하였다 (P<0.01)(P<0.01). 5. 혈장과 양수 내 아스코르비산 농도는 정상 임부군보다 만삭 전 조기양막파열군에서 모두 유의하게 감소하였다 (P<0.05) (P<0.01). 6. 혈장과 양수 내 요산, 베타-카로텐, 레티놀, 알파-토코페롤, 감마-토코페롤 농도는 서로 간에 유의한 차가 없었다. 결론: 만삭 전 조기양막파열 임부의 정맥혈장과 양수 내 염증성 cytokine 반응이 증가하였고, 지질과산화가 증가하고, 또한 항산화능은 감소하는 산화적 스트레스를 나타내었으며, 항산화제 중 아스코르빈산이 감소하였음을 알 수 있었다. 이러한 결과는 항산화 비타민인 아스코르빈산이 만삭 전 조기양막파열 병태생리에 중요한 역할을 할 것임을 시사하고 있다.
Abstract
Objective: To evaluate their roles in the pathophysiology of preterm premature rupture of membranes (PPROM), we checked interleukin (IL)-6, lipid peroxide, oxygen-radical absorbance capacity (ORAC) and antioxidant vitamin in the venous plasma and amniotic fluid of women with PPROM. Methods: Venous plasma and amniotic fluid was taken from 20 normal pregnant women and 20 PPROM pregnancy women. IL-6 levels was determined by enzyme-linked immunosorbent assay. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC levels and the antioxidant levels were measured by Cao’s method and by high performance liquid chromatography. Results: The IL-6 levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The lipid peroxide levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ORAC values in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ORAC values/lipid peroxide levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ascorbic acid levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.05, P<0.01). Conclusion: This result suggest that the increased inflammatory bioactivity, increased lipid peroxidation and decreased antioxidant activity may be involved in the pathophysiology of PPROM. Low levels of ascorbic acid appears to be an important determinant of PPROM.
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