【摘要】 目的：探讨NOD样受体热蛋白结构域相关蛋白6(NLRP6)、半胱氨酸天冬氨酸蛋白酶-4(Caspase-4)在青海不同海拔地区孕妇胎膜早破（PROM）宫内感染中的表达及意义。方法：收集2023年10月—2025年5月在我院收治的150例住院分娩的PROM孕妇的临床资料，根据胎盘组织病理检查结果，分为感染组58例和未感染组92例；再以海拔高度不同，将两组孕妇进一步分组，分为海拔>2 500 m感染组21例和海拔≤2 500 m感染组37例，海拔> 2 500 m未感染组32例和海拔≤2 500 m未感染组60例。采用免疫组织化学法及实时荧光定量聚合酶链反应（RT-qPCR）测定胎膜组织NLRP6、Caspase-4的表达水平，比较各组间指标差异，并分析影响PROM宫内感染的相关因素。结果：感染组C反应蛋白（CRP）、降钙素原（PCT）水平分别为（14.30±4.92）mg/mL、（0.79±0.34）ng/mL，胎膜组织中NLRP6、Caspase-4的mRNA表达水平为2.12±1.69、1.37±1.06，均高于未感染组（P<0.05）。无论感染组还是未感染组，海拔>2 500 m组的CRP、PCT水平、胎膜组织NLRP 6、Caspase-4平均阳性面积占比均高于海拔≤2 500 m组（P<0.05）。Logistic回归分析结果显示，CRP、PCT、NLRP6及Caspase-4是宫内感染的危险因素（P<0.05）。结论：NLRP6、Caspase-4在本地区PROM孕妇宫内感染患者胎膜组织中高表达；CRP、PCT、NLRP6、Caspase-4是PROM孕妇宫内感染的危险因素。更多还原

【Abstract】 Objective: To explore the expression and significance of NOD-like receptor pyrin domain-containing protein 6(NLRP6) and inflammatory caspase-4(Caspase-4) in intrauterine infection of premature rupture of membranes(PROM) in pregnant women at different altitudes in Qinghai. Methods: Clinical data of 150 PROM pregnant women who delivered in our hospital from October 2023 to May 2025 were collected. According to placental histopathological results, they were divided into the infection group(58 cases) and non-infection group(92 cases). Both groups were further stratified by altitude: 21 cases in the infection group with altitude >2 500 m, 37 cases in the infection group with altitude ≤ 2 500 m, 32 cases in the non-infection group with altitude >2 500 m, and 60 cases in the non-infection group with altitude ≤ 2 500 m. Immunohistochemistry and real-time quantitative polymerase chain reaction(RT-qPCR) were used to detect the expression levels of NLRP6 and Caspase-4 in fetal membrane tissues. Differences in indicators between groups were compared, and related factors affecting intrauterine infection of PROM were analyzed. Results: The levels of C-reactive protein(CRP) and procalcitonin(PCT) in the infection group were(14.30±4.92) mg/L and(0.79±0.34) ng/mL, respectively. The mRNA expression levels of NLRP6 and Caspase-4 in fetal membrane tissues were 2.12±1.69 and 1.37±1.06, all significantly higher than those in the non-infection group(P < 0.05). In both the infection and non-infection groups, the levels of CRP, PCT, and the average positive area ratios of NLRP6 and Caspase-4 in fetal membrane tissues were higher in the altitude >2 500 m subgroup than in the altitude ≤ 2 500 m subgroup(P<0.05). Logistic regression analysis showed that CRP, PCT, NLRP6, and Caspase-4 were risk factors for intrauterine infection(P < 0.05). Conclusion: NLRP6 and Caspase-4 are highly expressed in fetal membrane tissues of PROM pregnant women with intrauterine infection in this region. CRP, PCT, NLRP6, and Caspase-4 are risk factors for intrauterine infection in PROM pregnant women.更多还原