早期先兆流产细胞因子的检测及临床价值分析  

Expression and Clinical Value of Cytokines in Early Threatened Abortion

作　　者：邓飞涛[1] 欧阳为相[1] 朱剑文[1] 舒心 DENG Feitao;OUYANG Weixiang;ZHU Jianwen;SHU Xin(Department oF Obstetrics and Gynecology , Union Hospital , Tongji Medical College , Huazhong University of Science and Technology, Wuhan , 430022 , China)

机构地区：[1]华中科技大学同济医学院附属协和医院妇产科,武汉市430022

出　　处：《医学分子生物学杂志》2019年第5期483-486,共4页Journal of Medical Molecular Biology

基　　金：国家自然科学基金面上项目(No. 30971072).

摘　　要：目的探讨检测孕妇外周血中细胞因子表达水平变化对早期先兆流产进行预测的临床价值.方法选择早期先兆流产患者40例为早期先兆流产组,同期正常早孕产检孕妇45例为对照组.采用流式荧光法检测两组孕妇外周血清中 IL ( Interleukin, IL)-2、 IL-4、 IL-6、 IL-10、 TNF-α( tumor necrosis factor, TNF-α)和γ干扰素(interferon-γ, IFN-γ)的表达水平,分析各细胞因子在两组患者中的表达水平,并采用多因素Logistic回归方法分析各细胞因子表达水平与早期先兆流产发病风险的相关性.结果早期先兆流产患者外周血中IL-10、 TNF-α水平分别为(4. 47 ± 0. 61)、(5. 38 ± 2. 39) pg/ml,正常组孕妇外周血中IL-10、 TNF-α的表达水平分别为(4. 99 ± 0. 56)、(4. 36 ± 0. 41) pg/ml,经统计学分析,两组IL-10、 TNF-α水平相比较,差异均有显著性意义(P<0. 05).而两组中IL-2、 IL-4、 IL-6、 IFN-γ水平相比较则均无显著性差异(P>0. 05).采用多因素logistic回归分析显示:细胞因子IL-10表达水平降低、 TNF-α表达水平增高均是影响早期先兆流产发生风险的独立因素.同时,依据上述分析结果,建立了在早孕期联合检测孕妇外周血中细胞因子IL-10、 TNF-α水平来预测早期先兆流产发生概率的模型.结论早孕期联合检测细胞因子IL-10、 TNF-α表达水平变化在早期先兆流产风险预测中具有较高的临床价值.Objective To explore the predictive value of combined detection of cytokines in maternal peripheral blood for assessing the risk of early threatened abortion. Methods 40 patients with early threatened abortion were included in an early threatened abortion group, and 45 pregnant women on regular early-stage maternity examination during the same period served as controls. The serum expression of peripheral IL-2, IL-4, IL-6, IL-10, IL-6, TNF-alpha and IFN-gamma in the two groups was flow cytometrically detected and the difference in and significance of expression lev-els of cytokines between the two groups were analyzed. The correlation between the expression of cy-tokines and the risk of early threatened abortion was analyzed by multivariate logistic regres-sion. Results The levels of IL-10 and TNF-alpha in peripheral blood of patients with early threat-ened abortion were 4. 47 ± 0. 61 pg/mL and 5. 38 ± 2. 39 pg/mL, respectively;the expression lev-els of IL-10 and TNF-alpha in peripheral blood of normal pregnant women were 4. 99 ± 0. 56 pg/mL and 4. 36 ± 0. 41 pg/mL, respectively. Statistical analysis showed that there were significant differ-ences in IL-10 and TNF-alpha levels between the two groups ( P<0. 05), but no significant differ-ence was found in other cytokines (IL-2, IL-4, IL-6, INF-γ) levels between the two groups ( P>0. 05). Multivariate logistic regression analysis showed that the increased expression of cytokines IL-10 and TNF-alpha were independent factors influencing the risk of early threatened abortion. Moreover, on the basis of the aforementioned results, a model was established to predict the probability of early threatened abortion by detecting the levels of cytokines IL-10 and TNF-alpha in the peripheral blood of pregnant women during the middle and late pregnancy. Conclusion The combined detection of IL-10 and TNF-alpha levels during early-stage pregnancy is of high value in predicting the risk for early threatened abortion.

关 键 词：细胞因子 白细胞介素10 肿瘤坏死因子Α 早期先兆流产 多因素LOGISTIC回归分析 预测模型 

分 类 号：R714.21[医药卫生—妇产科学]