早期不明原因流产患者氧化应激指标与微炎症状态的相关性

Correlation between oxidative stress index and microinflammation state in patients with early unexplained spontaneous abortion

目的:检测早期不明原因自然流产患者氧化应激产物和机体的微炎症状态,探讨不明原因自然流产的发病机制。方法:以50例早期不明原因自然流产患者为研究组,50例同期正常早孕要求人工流产的妇女(正常早孕组)和20例健康妇女(健康非孕组)为对照组。检测血浆TNF-α、hs-CRP、IL-6等炎症反应产物和8-isoprostane、MDA、ox-LDL等氧化应激产物的浓度。结果:研究组血浆8-isoprostane、ox-LDL的浓度分别为(148.27±39.35)pg/ml、(689.15±152.06)μg/L,均高于对照组(正常早孕妇女和健康非孕妇女),差异有统计学意义;血浆MDA为(5.13±0.12)μmol/L,研究组也高于对照组,但差异无统计学意义(P>0.05)。研究组TNF-α、hs-CRP、IL-6的浓度分别为(23.53±11.35)pg/ml、(3.84±1.26)mg/L、(28.72±17.38)pg/ml,均高于正常早孕组〔(11.45±6.82)pg/ml、(1.82±1.25)mg/L、(16.79±11.19)pg/ml,P<0.05、P<0.01、P<0.05〕和健康非孕组〔(8.86±1.39)pg/ml、(1.46±1.02)mg/L、(13.35±4.01)pg/ml,P<0.05、P<0.01、P<0.01〕;正常早孕组也稍高于健康非孕组,但两组差异无统计学意义(P>0.05)。早孕流产患者8-isoprostane及ox-LDL均与hs-CRP、IL-6、TNF-α呈显著正相关(P<0.01、P<0.05),MDA与hs-CRP、IL-6、TNF-α无相关性(P>0.05)。结论:正常妊娠存在炎症反应和氧化应激,氧化应激失衡和微炎症状态的加剧及两者的相互作用可能在早期不明原因自然流产中发挥重要作用。干预氧化应激及炎症反应可能有利于控制早期不明原因流产的发生和发展。

Objective：To detect the oxidative stress products and microinflammation state in patients with early unexplained spontaneous abortion,explore the pathogenesis of unexplained spontaneous abortion. Methods：50 patients with early unexplained spontaneous abortion were selected as study group,50 normal early pregnant women demanding artificial abortion at the same time were selected as normal early pregnancy group,and 20 healthy women were selected as non-pregnancy group.The contents of inflammatory reaction products（tumor necrosis factor-alpha（TNF-α）,high-sensitive C-reactive protein（hs-CRP） and interleukin-6（IL-6）） and oxidative stress products（8-isoprostane,malondialdehyde（MDA） and oxidized low density lipoprotein（ox-LDL）） in plasma were detected. Results：The plasma concentrations of 8-isoprostane and ox-LDL in study group were（148.27±39.35） pg/ml and（689.15±152.06） μg/L,respectively,which were significantly higher than those in normal early pregnancy group and non-pregnancy group;the plasma level of MDA in study group was（5.13±0.12） μmol/L,which was higher than those in normal early pregnancy group and non-pregnancy group,but there was no significant difference（P0.05）.In study group,the plasma concentrations of TNF-α,hs-CRP and IL-6 were（23.53±11.35） pg/ml,（3.84±1.26） mg/L and（28.72±17.38） pg/ml,respectively,which were significantly higher than those in normal early pregnancy group（（11.45±6.82）pg/ml,（1.82±1.25）mg/L,（16.79±11.19）pg/ml,P0.05,P0.01,P0.05） and non-pregnancy group（（8.86±1.39） pg/ml,（1.46±1.02） mg/L,（13.35±4.01） pg/ml,P0.05,P0.01,P0.01）;the concentrations of above-mentioned indexes in normal early pregnancy group were slightly higher than those in non-pregnancy group,but there was no significant difference（P0.05）.In study group,there was positive correlation between 8-isoprostane,ox-LDL and hs-CRP,IL-6,TNF-α,respectively（P0.01,P0.05）;while there was no correlation between MDA and hs-CRP,IL-6,TNF-α（P0.05）. Conclusion：Inflammatory reaction and oxidative stress exist in normal pregnancy,the aggravation of oxidative stress unbalance and microinflammation state and their interaction may play important roles in early unexplained spontaneous abortion;intervention of oxidative stress and inflammatory reaction may be helpful to control the occurrence and development of early unexplained spontaneous abortion.