Sibel ÖZLER, Hacer Cavidan GÜLERMAN, Leyla MOLLAMAHMUTOĞLU

PRETERM EYLEMİN ERKEN TANISINDA INTERLÖKİN-8’İN PREDİKTİF DEĞERİ

Amaç: Preterm eylemi başlatan faktörler kesin olarak bilinmese de enfeksiyonun uterin kontrasksiyonları başlatmakta önemli bir rol aldığı düşünülmüş ve yapılan çalışmalarda proinflamatuvar sitokin olan interlökin-8 IL-8 ’in diğer enfeksiyon markerlarına mikro c-reaktif protein m-CRP , sedimentasyon, lökosit sayısı göre daha erken dönemde, ilk 24 saatte yükseldiği saptanmıştır. Çalışmada IL-8’in preterm eylemde erken enfeksiyon markerı olarak kullanılıp kullanılamayacağının araştırılması ve rutin olarak kullandığımız enfeksiyon markerlarına göre erken dönemde yükseliyor olmasının preterm eylemi tetikleyen enfeksiyonun erken teşhisini sağlayıp sağlamayacağı araştırılmaktadır. Yöntem ve Gereçler: 2010 yıllında Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesine preterm eylem tanısı ile kabul edilen 24-34. hafta arası 56 gebe ve 24-34 hafta arası 27 kontrol hastasının maternal serum IL-8, m-CRP, eritrosit sedimentasyon hızı ve beyaz küre düzeylerini ölçmek için kan alındı. Bu örneklerden IL8 ELIZA ile çalışıldı. Alt genital yolların enfeksiyonunu saptamak için tüm hastalardan servikovaginal kültür alındı. Bulgular: Çalışma grubunda ortalama IL-8 düzeyini n=56 ; serviks kültürü - olan hastalarda 17,96 ± 12,405pg/ml ve serviks kültürü + olan hastalarda 18,20 ± 15,428 pg/ml’ye karşı kontrol grubunda n=27 4,97 ± 2,856 pg/ml olarak bulduk. Kontrol ve preterm eylem grubu arasında istatistiksel olarak anlamlı fark bulunmuştur p=0,000

Anahtar Kelimeler:

Interlökin-8, bakteriyel vaginosis pre- term doğum, preterm eylem, intra-amniotik inflamasyon.

PREDICTIVE VALUE OF INTERLEUKIN-8 IN THE EARLY DIAGNOSIS OF PRETERM LABOR

Aim: Although the factors that initiate preterm activities are not known exactly, it is considered that the infection plays an important role in the initiation of the contractions of the uterus and in the experiments conducted it was observed that IL-8 which is a pro-inflammatory cytokine, elevated at an earlier stage than micro C-reactive Protein m-CRP: , sedimentation and leukocyte count. The aim of this study is to evaluate whether IL-8 can be used as an early infection marker that can provide early diagnosis of the infection which triggers preterm labour and rises at an earlyier stage than the elevation of the erythrocyte sedimentation and leukocyte counts . Material and Methods: Blood was taken from 56 pregnant women group A, n=56 who were diagnosed as having preterm labour after admitted to our hospital, and from the control group which was formed of 27 normal pregnant patients in their 24-34 weeks of gestation. We checked the levels of maternal serum ınterleukin-8, C-Reactive Protein m-CRP , sedimentation ratio ESR and white blood cell WBC of every patient. IL-8 ELISA was used in these samples. Cervicovaginal culture was obtained from all the patients to determine the infection of subgenital pathogens. Results: In the working group, on an average we found IL-8 level n=56 , and in the patients with cervix CX culture - 17,96+/-12,405 pg/ml and in patients with CX culture + 18,20+15,428 pg/ml and in the control group n=27 4,97+2.856 pg/ml. Astatistically significant dif- ference, statistically, was found between the control and preterm labor group p=

Keywords:

Interleukin-8 bacterial vaginosis, preterm delivery, preterm labour, intra-amniotic inflammation,

PDF

___

Lawn JE, Cousens S,Zupan J, for the Neonatal Survival Steering Team. Four million neonatal deaths: when? where? why? Lancet 2005; : 891-900.
Saji F, Samezima Y, Kamiura S, Sawai K, Shimoya K. Cytokine pro- duction in chorioamnionitis. J Reprod Immunol. 2000; 47: 185-96.
Turhan MÖ, Karabulut A. Maternal serum IL-6 levels in preterm la- bor. Prediction of admission to delivery interval J Perinat Med. 2000; : 133-139.
Robert L, Goldenberg M.D., John C, Hauth M.D, and Williams And- rews.Intrauterıne ınfection and preterm delivery. 2000;20:1500-5.
Yoon BH, Romeo R, Kim M, et al. Clinical implications of detection of Ureaplasma urealyticum in the amniotic cavity with the polymerase chain reaction. Am J Obstet Gynecol 2000; 183: 1130-7.
Yoon BH, Jun JK, Park KH, Syn HC, Gomez R, Romero R. Serum C-reactive protein, hite blood cell count, and amniotic fluid white blo- od cell count in women with preterm premature ruprure of membranes. Obstet. Gynecol. 1996; 88: 1034-40.
Shimoya K, Matsuzaki N, Taniguchi T, Okada T, Saji F, Murata Y. In- terleukin-8 level in maternal serum as a marker for screening of histolo- gical chorioamnionitis at term. Int J Gynaecol Obstet. 1997; 57: 153-9.
Törnblom SA, Klimaviciute A, Byström B, Chromek M, Brauner A, Ekman-Ordeberg G Non-infected preterm parturition is related to inc- reased concentrations of IL-6, IL-8 and MCP-1 in human cervix. Rep- rod Biol Endocrinol. 2005; 25: 3-39.
Bogavac MA, Brkić S. Serum proinflammatory cytokine interleu- kin-8 as possible infection site marker in preterm deliveries. J Perinat Med. 2009; 37: 707-8.
Waranuch P, Matthew W. Gillman, Kaumudi J. Joshipura, Paige L. Williams, Chester W, Douglass and Janet W, Rich-Edwards I. Plasma C-Reactive Protein in Early Pregnancy and Preterm Delivery, 2005; 12
Nowak M, Oszukowski P, Pieta A, Szpakowski M, Malafiej E, Mli- nowski A, Wierzbicka E, Drzazga W. The use of maternal serum cyto- kines in predicting of the efficacy of tocolytic therapy in case of the threat of preterm labor 1998; 69: 997-1002.