妊娠期被动吸烟与母亲血清和脐带血清炎性因子的关系  

Associations of exposure to secondhand smoke during pregnancy with proinflammatory factors in maternal and umbilical serum

作　　者：牛中正 谢传波[1] 丁鹏[1] 何艳辉[1] 林建苗[2] 袁仕新[3] 郭晓玲[4] 贾德勤[5] 陈维清[1] 

机构地区：[1]中山大学公共卫生学院流行病与卫生统计系,广东广州510800 [2]深圳市妇幼保健院信息科,广东深圳518000 [3]深圳市妇幼保健院科教科,广东深圳518000 [4]佛山市妇幼保健院产科,广东佛山5280005 [5]佛山市妇幼保健院妇科,广东佛山528000

出　　处：《中华疾病控制杂志》2014年第3期190-193,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(30872164;81172758)

摘　　要：目的探讨母亲孕期被动吸烟（passive smoking）与母亲外周血清及脐带血清中炎性因子水平的关系。方法调查79名孕产妇的一般人口学、妇产科学特征及在孕期的被动吸烟情况，采集孕产妇外周静脉血及脐带静脉血，检测血清单核细胞趋化因子-1（monocyteche motactic protein-1，MCP-1）、白介素-6（interleukin-6，IL-6）、肿瘤坏死因子-α（tumor necrosis factor—α，TNF-α）、白介素1β（interleukin-1β，IL-1β）、C反应蛋白（C—reactive protein，CRP）和血管细胞粘附因子-1（soluble vascular cell adhesion molecule-1，VCAM-1）。在控制年龄、孕周、婚姻状态、教育水平、家庭收入、孕产妇孕前体质指数（body mass index，BMI）、产次、胎儿性别等？昆杂因素后，采用有序Logistic回归模型分析母亲孕期被动吸烟暴露与母亲血清及脐血清中炎性因子水平的关系。结果79名调查对象中46人（58．2％）报告其在孕期有被动吸烟暴露，28人（35．4％）报告被动吸烟暴露平均每天为1～15min，18人（22．8％）报告被动吸烟暴露平均每天超过15min。在控制混杂因素后，与非暴露者相比，每天平均暴露1～15min者母血清中IL－1β（OR=3．00，95％C／：1．10—8．14）和CRP（OR=4．10，95％C／：1．47～11．47）水平升高，平均每天暴露超过15min者母血清IL-6（OR=5．19，95％C／：1．56—17．29）和TNF-α（OR：6．87，95％C／：1．97～23．96）水平升高。与非暴露者相比，平均每天暴露超过15min者脐带血清IL－1β（OR=0．21，95％CI：0．07～0．59）水平降低。结论母亲孕期被动吸烟暴露对母亲和胎儿的炎性反应有所不同，对母亲的炎性反应影响较大，对胎儿的炎性反应影响较小。Objective To investigate the associations of passive smoking during pregnancy with proinflammatory factors in maternal peripheral and umbilical serum. Methods 79 pregnant women were inquired about the exposure of passive smoking during pregnancy as well as demographic and obstetric information. Maternal and umbilical sera were sampled for tes- ting six inflammatory factors ： monocyte chemotactic protein-1 （ MCP-1 ）, interleukin-6 （ IL-6 ）, tumor necrosis factor-or （ TNF- oL）, interleukin-113（ IL-113）, C-reactive protein（CRP） and soluble vascular cell adhesion molecule-1 （ VCAM-1 ）. After con- trolling for potential confounders of pre-pregnancy BMI, parity, and fetal gender, a serial of ordinal logistic regression models was performed to test the associations between passive smoking during pregnancy and proinflammatory factors in maternal peripheral and umbilical sera. Results 46（58.2% ） of the 79 investigated pregnant women had ever exposed to passive smoking during pregnancy, 28（35.4% ） for 1-15 minutes per day, 18（22. 8% ） for over 15 mintites per day. Compared with those without exposure to passive smoking, pregnant women with exposure to passive smoking for 1-15 minutes per day had elevated maternal serum levels of IL-113 （ OR = 3.00,95% CI： 1.10-8.14） and CRP （ OR = 4. 1,95% CI： 1.47± 47 ）, and the pregnant women with exposure to passive smoking for over 15 minutes per day had elevated maternal serum levels of IL-6 （OR =5.19,95% CI：I. 56-17.29） and TNF-α （OR =6. 87,95% CI： 1.97-23.96） but decreased umbilical level of IL-113 （OR = 0. 21,95% CI：O. 07-0. 59 ）. Conclusions This study implicated that maternal exposure to passive smoking during pregnancy might differently induced maternal and umbilical inflammatory responses, more seriously in matrix than in fetus.

关 键 词：烟草烟污染 孕妇 血清 

分 类 号：R181.26[医药卫生—流行病学] R714.14[医药卫生—公共卫生与预防医学]