Th1/Th2平衡偏移在苯并[a]芘宫内暴露与胚胎停育关联中的中介效应  

The mediating effect of Th1/Th2 balance deviation in the association between B[a]P intrauterine exposure and embryonic arrest

作　　者：李福星 刘莎 张嘉宇 籍静茹[2] 武嫣斐[2] 曹九茹 魏俊妮 LI Fuxing;LIU Sha;ZHANG Jiayu;JI Jingru;WU Yanfei;Cao Jiuru;WEI Junni(Department of Epidemiology,School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Department of Obstetrics,The First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学公共卫生学院流行病学教研室,太原030001 [2]山西医科大学第一医院产科,太原030001

出　　处：《中华疾病控制杂志》2024年第11期1264-1269,共6页Chinese Journal of Disease Control & Prevention

基　　金：山西省应用基础研究项目(201901D111206);山西省卫生健康委科研计划项目(2020086)。

摘　　要：目的探讨苯并[a]芘(benzo[a]pyrene,B[a]P)宫内暴露与胚胎停育的关联,以及辅助性T细胞1/辅助性T细胞2(helper T cell 1/helper T cell 2,Th1/Th2)平衡偏移的中介效应。方法选取胚胎停育患者与正常妊娠但自愿人工流产的女性作为研究对象(245名)。检测研究对象绒毛组织中7,8-二羟-9,10-环氧苯并[a]芘(7,8-dihydroxy-9,10-epoxy-benzo[a]pyrene,BPDE)-DNA加合物与白细胞介素(interleukin,IL)-2、干扰素-γ(interferon-γ,IFN-γ)、IL-4、IL-10水平。采用logistic回归分析模型分析B[a]P暴露与胚胎停育的关联,运用Bootstrap法分析Th1/Th2平衡偏移的中介效应。结果调整协变量后,BPDE-DNA加合物的中高暴露、高暴露水平发生胚胎停育的风险分别是低暴露水平的5.66倍(aOR=5.66,95%CI:2.00~16.01,P<0.001)、5.63倍(aOR=5.63,95%CI:1.97~16.14,P<0.001);中介分析结果显示,B[a]P对胚胎停育的总效应为1.220(0.501~1.939),Th1/Th2平衡偏移介导的中介效应为0.328(0.078~0.716),中介比例占26.89%。结论B[a]P暴露是胚胎停育的危险因素,且Th1/Th2失衡发生Th1型偏移是B[a]P暴露致胚胎停育的中介变量。Objective To investigate the association between exposure to benzo[a]pyrene(B[a]P)and embryonic arrest,and the mediating effects of helper T cell 1/helper T cell 2(Th1/Th2)balance deviation.Methods A total of 245 women with embryonic arrest and women with normal pregnancy who voluntarily induced abortion were selected as the study objects.The levels of 7,8dihydroxy-9,10-epoxy-benzo[a]pyrene(BPDE)-DNA adducts and interleukin(IL)-2,interferon-γ(IFN-γ),IL-4,IL-10 in villus tissues were detected.Logistic regression model was used to analyze the correlation between B[a]P exposure and embryonic arrest,and Bootstrap method was used to analyze the mediating effect of Th1/Th2 balance deviation between them.Results After adjusting for covariates,it was found that the risk of embryonic arrest at medium-high exposure level and high exposure level of BPDE-DNA adducts was 5.66 times(aOR=5.66,95%CI:2.00-16.01,P<0.001)and 5.63 times(aOR=5.63,95%CI:1.97-16.14,P<0.001)higher than that at low exposure level,respectively;The results of mediating analysis showed that B[a]P had a total effect of 1.220(0.501-1.939)on embryonic arrest,with a mediating effect caused by Th1/Th2 balance deviation of 0.328(0.078-0.716),accounting for 26.89%.Conclusions B[a]P exposure is a risk factor for embryonic arrest,and Th1/Th2 imbalance occurring with a Th1-Type deviation is a mediating variable of embryonic arrest caused by B[a]P exposure.

关 键 词：苯并[A]芘 胚胎停育 辅助性T细胞1/辅助性T细胞2 平衡偏移 中介效应 

分 类 号：R714.21[医药卫生—妇产科学]