| 邬瑞霞,雷蔚华,龚景进,蒋静文,刘艳红.妊娠期肝内胆汁淤积症患者血清总胆汁酸水平与炎症因子、Th17/Treg平衡及母婴结局的关系研究[J].,2021,(13):2560-2563 |
| 妊娠期肝内胆汁淤积症患者血清总胆汁酸水平与炎症因子、Th17/Treg平衡及母婴结局的关系研究 |
| The Study of Relationship between Serum Total Bile Acid Level, Inflammatory Factor, Th17/Treg Balance and Maternal and Infant Outcomes in Patients with Intrahepatic Cholestasis during Pregnancy |
| 投稿时间：2021-01-23 修订日期：2021-02-17 |
| DOI：10.13241/j.cnki.pmb.2021.13.034 |
| 中文关键词: 妊娠期 肝内胆汁淤积症 总胆汁酸 炎症因子 Th17/Treg平衡 母婴结局 |
| 英文关键词: Pregnancy Intrahepatic cholestasis Total bile acid Inflammatory factors Th17/treg balance Maternal and infant outcomes |
| 基金项目:国家自然科学基金项目（81671440） |
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| 中文摘要: |
| 摘要 目的：分析妊娠期肝内胆汁淤积症（ICP）患者血清总胆汁酸（TBA）水平与炎症因子[肿瘤坏死因子-α（TNF-α）、白介素-12（IL-12）、白介素-6（IL-6）]、Th17/Treg平衡及母婴结局的关系。方法：选取2018年1月-2020年12月期间我院收治的ICP患者94例为ICP组，另选取同期来我院产检的90例正常妊娠妇女为对照组，对照组孕妇于体检当日、ICP组于入院次日在早晨空腹状态下抽取外周静脉血，应用流式细胞仪测定Th17、Treg细胞比率，采用全自动生化分析仪对血清TBA水平进行检测与分析，采用酶联免疫吸附法检测TNF-α、IL-6、IL-12水平。根据ICP孕妇血清TBA水平分为低TBA组（<40 μmol/L，58例）与高TBA组（≥40 μmol/L，36例），观察两组围生儿结局、产妇妊娠结局、新生儿并发症发生率。结果：ICP组的TBA、TNF-α、IL-6、IL-12、Th17、Th17/Treg均高于对照组，Treg低于对照组（P<0.05）。低TBA组剖宫产率低于高TBA组，阴道自然分娩率高于高TBA组（P<0.05），两组阴道助产率组间对比差异无统计学意义（P>0.05）。低TBA组胎儿宫内发育迟缓率、胎儿宫内窘迫率低于高TBA组（P<0.05）。两组新生儿窒息率、围生儿死亡率组间对比差异无统计学意义（P>0.05）。低TBA组新生儿并发症总发生率低于高TBA组（P<0.05）。Pearson线性相关分析结果显示，血清TBA与TNF-α、IL-6、IL-12、Th17/Treg比值呈正相关（P<0.05）。结论：ICP患者的TBA水平越高，母婴不良结局发生率越高，此外，ICP患者具有明显的炎症反应和Th17/Treg平衡情况，促进疾病进展。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the relationship between serum total bile acid (TBA) level and inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-12 (IL-12), interleukin-6 (IL-6)], Th17/Treg balance and maternal and infant outcomes in patients with intrahepatic cholestasis during pregnancy (ICP). Methods: 94 patients with ICP in our hospital from January 2018 to December 2020 were selected as ICP group, 90 normal pregnant women who were examined in our hospital at the same time were selected as control group. Peripheral venous blood was extracted from pregnant women in the control group on the day of physical examination and in the ICP group on the day after admission on a fasting basis in the morning, the ratio of Th17 and Treg cells was measured by flow cytometry. The serum TBA level was detected and analyzed by automatic biochemical analyzer. TNF-α IL-6 and IL-12 levels were detected by enzyme-linked immunosorbent assay. According to the serum TBA level of ICP pregnant women, the patients were divided into low TBA group (<40 μmol/L, 58 cases) and high TBA group (≥40 μmol/L, 36 cases). The perinatal outcome, maternal pregnancy outcome and incidence of neonatal complications were observed in the two groups. Results: TBA, TNF-?, IL-6, IL-12, Th17, Th17/Treg in ICP group were higher than those in control group, and Treg was lower than that in control group(P<0.05). The cesarean section rate in low TBA group was lower than that in high TBA group, and the vaginal natural delivery rate was higher than that in high TBA group (P<0.05). There was no significant difference in vaginal midwifery rate between the two groups (P>0.05). The rate of fetal intrauterine growth retardation and fetal distress in low TBA group were lower than those in high TBA group(P<0.05). There was no significant difference in neonatal asphyxia rate and perinatal mortality rate between the two groups (P>0.05). The total incidence of neonatal complications in low TBA group was lower than that in high TBA group(P<0.05). Pearson linear correlation analysis showed that serum TBA was positively correlated with TNF-α, IL-6, IL-12 and Th17/Treg ratio(P<0.05). Conclusion: The higher the TBA level of patients with ICP, the higher the incidence of adverse outcomes between maternal and infant. In addition, patients with ICP have obvious inflammatory response and Th17/Treg balance, which promotes the progress of the disease. |
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