妊娠期高血压疾病外周血IL-12、TNF-α水平变化及其与妊娠结局的相关性  

Changes of peripheral blood IL-12 and TNF-αand their correlation with pregnancy outcomes in hypertensive disorders of pregnancy

作　　者：张蕊[1] 张瑾[1] ZHANG Rui;ZHANG Jin(Department of Obstetrics and Gynecology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院妇产科,北京100038

出　　处：《现代免疫学》2022年第2期121-126,共6页Current Immunology

摘　　要：为探讨妊娠期高血压疾病(hypertensive disorder of pregnancy,HDP)患者外周血炎性因子水平变化及与妊娠结局的相关性,选取192例HDP患者为HDP组,其中妊娠期高血压患者64例、轻度子痫前期患者82例、重度子痫前期患者46例,另选取同期100例正常产检孕妇为对照组。采用ELISA检测外周血IL-2、IL-10、IL-12、TNF-α、IFN-γ水平,免疫透射比浊法测定CRP水平。比较HDP组与对照组的炎性因子水平和不良妊娠结局;比较HDP患者妊娠结局良好组与不良组炎性因子水平,并分析其与不良妊娠结局的相关性;绘制ROC曲线,分析炎性因子对不良妊娠结局的预测价值。结果显示,不同HDP分期组患者外周血IL-2、IL-12、TNF-α水平较对照组升高(P<0.05),IL-10水平较对照组降低(P<0.05);重度子痫前期组IL-12、TNF-α水平高于其他HDP分期组(P<0.05)。HDP组有指征的剖宫产、产后出血、早产或过期产、低体重儿、新生儿窒息发生率均显著高于对照组(P<0.05)。HDP患者中妊娠结局良好组外周血IL-12、TNF-α水平均显著低于妊娠结局不良组(P<0.05)。HDP组外周血IL-12、TNF-α水平均与有指征的剖宫产、产后出血、早产或过期产、低体重儿、新生儿窒息发生率呈正相关(P<0.05)。外周血IL-12、TNF-α及二者联合预测不良妊娠结局ROC曲线的AUC分别为0.890、0.845、0.956。该研究提示,HDP患者外周血多种炎性因子水平异常波动,其中IL-12、TNF-α水平升高与病情严重程度、不良妊娠结局密切相关,IL-12、TNF-α有望成为HDP不良妊娠结局的预测指标。To investigate the changes of peripheral blood inflammatory factors and their correlation with pregnancy outcomes of patients with hypertensive disorders of pregnancy(HDP),192 patients were recruited as HDP group including 64 cases of pregnancy-induced hypertension,82 cases of mild preeclampsia and 46 cases of severe preeclampsia.Another 100 pregnant women undergoing normal prenatal examination in the same pregnancy stage were included as non-hypertension controls.The levels of IL-2,IL-10,IL-12,TNF-α,and IFN-γin peripheral blood were determined by ELISA,and the level of CRP was analyzed by nephelometry.The expression of inflammatory factors and adverse pregnancy outcomes were compared between the HDP group and the control group.In addition,the levels of inflammatory factors between good and poor pregnancy outcome groups among HDP patients were analyzed and their correlations with adverse pregnancy outcomes were estimated.ROC curve was generated to estimate the predictive value of inflammatory factors on adverse pregnancy outcomes.The results showed that the peripheral blood levels of IL-2,IL-12,and TNF-αincreased in patients of all HDP groups compared to the control group(P<0.05),whereas the IL-10 level was lower than the control group(P<0.05).And the expressions of IL-12 and TNF-αof patients in severe preeclampsia group were higher than those in other HDP groups(P<0.05).The incidence rates of indicative cesarean section,postpartum hemorrhage,premature or post-term delivery,low birth weight infants,and neonatal asphyxia in the HDP groups were significantly higher than those in the control group(P<0.05).Inside the HDP groups,patients with good pregnancy outcomes had significantly lower levels of peripheral blood IL-12 and TNF-αcompared to those with poor outcomes(P<0.05).The peripheral blood levels of both IL-12 and TNF-αof HDP patients were positively correlated with the incidence rates of indicative cesarean section,postpartum hemorrhage,premature or post-term delivery,low birth weight infants,and neonatal

关 键 词：妊娠期高血压疾病 不良妊娠结局 白细胞介素12 肿瘤坏死因子Α 相关性 

分 类 号：R714.14[医药卫生—妇产科学]