Preliminary Study On Clinical Value Of CD138 In Premature Rupture Of Membranes

Research BackgroundSpontaneous rupture of fetal membranes before labor is called premature rupture of fetal membranes(PROM).PROM is one of the common perinatal complications that lead to adverse outcomes of mothers and children.The incidence rate has increased in recent years.PROM can cause premature birth,neonatal respiratory distress syndrome,chorioamnionitis,placental abruption,umbilical cord prolapse,fetal distress,etc.,which seriously affects the prognosis of mother and child.At present,the cause and mechanism of PROM are still not completely clear.Most studies believe that the cause of premature rupture of membranes is complex and is the result of various factors.Among them,genital tract infections are considered to be the main cause of premature rupture of membranes,Ascending infection of lower genital tract pathogens causes a strong inflammatory response that promotes membrane damage and rupture.Although clinical examination of maternal vaginal secretion-related pathogens has been strengthened,there is still no effective means to predict the occurrence of premature rupture of membranes.Ideally,PROM can be screened early to identify high-risk groups early,and then effective interventions can be taken to prevent it.CD 138(syndecan-1,Sdc-1),also known as multiligand proteoglycan-1,is a member of the syndecan family containing heparan sulfate proteoglycans(HSPGs),and is mainly expressed by epithelial and plasma cells in adult tissues.CD138 can regulate leukocyte recruitment,cancer cell proliferation and invasion,angiogenesis,microbial attachment and entry,host defense mechanisms,and matrix remodeling and is considered a target for microbial pathogens,especially in the early stages of infection.Our previous research confirmed that CD 138 was highly expressed in the membrane tissue of patients with premature rupture of membranes,and the correlation between CD138 and premature rupture of membranes was initially clarified.In this study,we used enzyme-linked immunosorbent assay(ELISA)to detect the expression level of CD138 in the plasma of patients with premature rupture of membranes,and based on the results,a receiver operating characteristic(ROC)curve was drawn to find new indicators that are more valuable for the prediction of premature rupture of membranes,in order to provide guidance for our clinical work.Research ObjectiveThrough the clinical experimental study of plasma CD138 and premature rupture of membranes,the levels of CD13 8 in the plasma of pregnant women in each group were detected to preliminary study of the relationship between plasma CD138 and premature rupture of membranes.And observe and record maternal and child outcomes,and further analyze the relationship between CD 13 8 and newborns,looking forward to provide new ideas for early screening of premature rupture of membranes in our clinical work,and thus improve the prognosis of mothers and children.Materials and MethodsAccording to the inclusion criteria,30 patients with Preterm premature rupture of membrane,40 patients with Term premature rupture of membranes and 40 patients with normal delivery were randomly selected to deliver in the obstetrics department of the fifth affiliated hospital of zhengzhou university on May 1,2019 and December 1,2019.The plasma was collected,and the expression of CD138 in the three groups of plasma was detected by enzyme-linked immunosorbent assay(ELISA).According to the experimental results,the expression difference of CD138 in the three groups was analyzed and the receiver operating characteristic(ROC)curve was drawn.The predictive value of CD 138 for premature rupture of membranes was analyzed,and the prognosis of mothers and children in the three groups were observed,Further analysis of the relationship between CD 138 and postnatal conditions of newborns.Research resultsThere were no statistically significant differences in age and weight between the three groups(P>0.05).ELISA results showed that plasma CD138 levels in the preterm premature rupture of membrane group,the term premature rupture of membrane group and the normal delivery group were(26.8±5.0)ng/ml,(25.6±4.9)ng/ml,(19.5±5.3)ng/ml,analysis of statistical results shows that there is a statistically significant difference in CD138 levels between the three groups(P<0.05).Draw the ROC curve,the area under the ROC curve is 0.821,the critical value is 20.3ng/ml,the sensitivity is 85.71%,the specificity is 72.5%,the positive predictive value is 84.5%,and the negative predictive value is 74.4%.Follow-up of three groups of maternal and child outcomes:the differences in the incidence of low birth weight infants,neonatal asphyxia,neonatal pneumonia,and neonatal pathological jaundice in the three groups were statistically significant(P<0.05),and the incidence of postpartum infections in the three groups There was no significant difference in the rate(P>0.05).Further analysis of the relationship between plasma CD138 levels and the outcomes of the three groups of newborns showed no significant difference(P>0.05).ConclusionThe expression of CD13 8 in the plasma of the three groups of pregnant women is statistically significant,CD138 may be of value in the prediction of premature rupture of membranes.There was also a statistically significant difference in the prognosis of the three groups of mothers and children,and CD138 has nothing to do with the outcome of three groups of newborns.We speculated that CD138 may be involved in the mechanism of premature rupture of membranes by mediating pathogen attachment and entry into host cells and inhibiting host defense mechanisms,enhancing inflammatory activity,weakening the membrane structure,and eventually leading to PROM.