米非司酮对引产胎儿细胞因子分泌、肝细胞增殖及肝功能影响的研究

The effect of Mifepristone on the cytokine secretion,hepatocyte proliferation,liver function in induced fetals

目的通过观察使用米非司酮对引产胎儿细胞因子分泌、肝细胞增殖及肝功能的影响,探讨米非司酮对胎儿安全性的影响。方法胎儿娩出后立即抽取脐动脉血,应用全自动生化分析仪对胎儿肝功能进行检测;应用放射性同位素-胸腺嘧啶核苷(3H-radioactive isotope Thy midine,3H-TdR)掺入实验,体外研究米非司酮对胎儿肝细胞增殖活性的影响;放射免疫分析研究血清白细胞因子-2(interleukin-2,IL-2)及肿瘤坏死因子(tumor necrosis factor,TNF)-α的水平。结果孕妇体内米非司酮用药组胎儿的肝功能无明显变化,但是肝细胞增殖能力明显受抑制,在体外实验的高浓度和低浓度组,用药组与对照组肝细胞增殖能力有显著差别,差异有统计学意义(P<0.05),提示高浓度米非司酮单纯体外应用可以明显抑制胎儿肝细胞增殖。用药组IL-2明显升高,与未用药组有明显区别,差异有统计学意义(P<0.05),而TNF-α的水平两组间无明显差别,差异无统计学意义(P>0.05),提示米非司酮有明显的促进IL-2分泌的作用。结论米非司酮对胎儿肝脏功能无明显影响,但是可以抑制肝细胞的增殖,还可明显促进IL-2分泌,从而影响胎儿的免疫系统功能,使胎儿体内免疫抑制反应减弱,免疫排斥反应增强。提示米非司酮对胎儿的安全性有一定的影响。

Objective To investigate the effect of Mifepristone on the eytokine secretion, hepatocyte proliferation, liver function in induced fetus and fetal well - being. Methods Immediately after the delivery, fetal peripheral blood was obtained for liver function detection using biochemical automatic analyzer; The effect of Mifepristone on Hepatoeyte proliferation was studied in vitro through ^3H -radioactive isotope Thy midine（ ^3H -TdR） incorporation assay; Serum eytokine of interleukin - 2 （ IL - 2 ） and tumor necrosis factor - α （ TNF - α ） were analyzed by radioimmunoassay（RIA）. Results The productivity of liver cells could be inhibited obviously that the difference was significant（ P 〈0. 05） between Mifepristione group and control group. In intro experiment, hepatocyte proliferation was significant difference（ P 〈0. 05 ） between Mifepristione group and control group. The level of IL- 2 was higher in experimnet group than that in control group that the difference was significant （ P 〈 0.05 ）. While the level of TNF - α was no difference （ P 〉 0.05 ） between Mifepristione group and control group. Conclusion Mifepristone has no effect on fetal liver function, but it can inhibit the productivity of fatal liver cells. Besides, Mifepristone can affect the expressions of cytokines, promote IL - 2 secretion significantly, weaken the reaction of immune depression and strengthen immunological rejection accordingly. So Mifepristone has effect on fetal well - being.