中文摘要：

目的：探讨脂质过氧化作用在足月胎膜早破（tPROM）发病机制中可能发挥的作用以及tPROM孕妇脂质过氧化与凝血状态改变的相关性。方法：以正常孕妇为对照，以定期产检且胎儿生长发育正常，在足月临产前胎膜破裂而无临床感染征象的孕妇32例为研究对象，分别对孕中期（16～23^＋6周）、孕晚期（28～36^＋6周）和孕足月临产前（37～40周）的新鲜中段尿液（经抹洗）进行抗原标记酶联免疫吸附法测定8-异前列腺素F2α（8．iso-PGF2α）的水平，且测定尿肌酐（Cr）的浓度，采用尿8-iso—PGF2α与尿Cr的比值以平衡患者肾脏的不同排泄功能，分析相关的凝血指标和妊娠结局。结果itPROM组中，孕中期与孕晚期尿液8-iso-PGFα。水平比较无显著性差异（P〉0．05），两者分别与对照组比较也无显著性差异（P〉0．05），孕足月时尿液8-iso-PGFα。水平均显著高于自身孕中、晚期和正常孕足月组（P〈0．05）。tPROM组孕足月时血细胞比容和纤维蛋白原明显高于正常组（P〈0．05），活化部分凝血活酶时间和凝血酶原时间明显低于正常（P〈0．05），但均与尿液8-iso—PGFα。水平无显著相关性（P〉0．05）。结论：tPROM孕妇破膜后临产前脂质过氧化作用明显增强。tPROM孕妇破膜后临产前血液处于高凝状态，可能与脂质过氧化作用增强无关。

英文摘要：

Aim： To investigate premature rupture of membrane at the changes of lipid peroxidation （LPO） level in pregnant women with term （tPROM） at different gestational stages, and to analyze the relationship between LPO and the changes coagulable state. Methods： Taking 35 healthy pregnant women as controls, 32 pregnant women whose fetal membranes ruptured before onset of labor were served as tPROM group. The pregnant women in tPROM group had no any sign of inflammation and delivered appropriated size babies at term. The fresh urine samples of all cases were collected in three gestational stages respectively： second trimester （16 - 23^＋6 weeks）, late pregnancy （28 - 36^＋6 weeks） and term pregnancy （37 - 40 weeks）. Enzyme-linked immunosorbent assay （ELISA） was used to determine 8-iso-prostagland- inF2α （ 8-iso-PGF2α ） levels in outcomes between normal and the urine samples. Moreover, the relative coagulation indexes tPROM group were also compared. Results： In tPROM group： and pregnant Urine 8-iso-PGF2α levels at term pregnancy were higher than those in the second trimester and late pregnancy, and they were also higher than those at term pregnancy of control group （P 〈 0. 05 ）. There were no significant differences of the urine 8-iso-PGF2α levels between tPROM group and control group in the second trimester and late pregnancy （P 〉 0. 05 ）. The hematocrit （HCT） and fibrinogen （FIB） levels of tPROM group were higher than those of control group （P 〈 0. 05 ）. Activated partial thromboplastin time （APTT） and prothrombin time （PT） of tPROM group were lower than those of control group （P 〈 0. 05 ）. HCT, FIB, APTT and PT of tPROM group did not correlate with the urine 8-iso-PGF2α level at term pregnancy （ P 〉 0. 05 ）. Conclusion： LPO of pregnant women with tPROM before parturiency is increased after rup- ture of fetal membranes. The blood of women with tPROM before parturiency is in hypercoagulable state, but that may not correlate with