妊娠期肝内胆汁淤积症IL-10、TNF-α表达变化及其与肝功能变化的关系

The expression levels of IL-10 and TNF-α in patients with intrahepatic cholestasis of pregnancy and the relationship with liver function

目的探讨白细胞介素10(interleukin-10,IL-10)、肿瘤坏死因子(tumor necrosis factor-alpha,TNF-α)在妊娠期肝内胆汁淤积症(ICP)孕妇胎盘组织中的表达及其与门冬氨酸转移酶(aspartate aminotransferase AST)、丙氨酸转移酶(alanineaminotransferase,ALT)的关系。方法选择2010年10月至2011年5月在新疆医科大学第一附属医院产科剖宫产分娩的ICP孕妇37例为ICP组,选择同期健康孕妇35例为对照组。采用Envision免疫组化法测定IL-10、TNF-α在孕妇胎盘组织中的定位与表达水平,术前静脉血测定肝功指标:AST,ALT,采用SPSS17.0统计软件进行统计分析,计量资料比较采用t检验;等级经秩转换后采用秩和检验并进行相关性分析。结果 IL-10、TNF-α在两组孕妇胎盘组织中均有表达,在ICP组中IL-10的阳性率明显低于对照组,而TNF-α的阳性率则明显高于对照组(P<0.05)。TNF-α与AST、ALT均呈正相关(r=0.270、0.246,P均<0.05),而IL-10与AST、ALT均呈负相关(r=-0.250、-0.128,P均<0.05)。结论 ICP患者母胎界面Th1型细胞因子TNF-α表达增加,而Th2型细胞因子IL-10表达降低,存在Th1偏移。细胞因子网络的失衡可能对肝脏产生免疫性损伤而参与了ICP的发病。

This study aims to investigate the expression and significance of IL-10 and TNF-α in the placenta with intrahepatic cholestasis of pregnancy（ICP）.Total of 37 ICP gravidas delivered by cesarean section were selected as the ICP group,and another 35 healthy pregnant women were chosen as control.Placentas of the all gravidas were collected for TNF-α and IL-10 proteins detection by Envision immunohistochemical method.The results showed that TNF-α and IL-10 were mainly expressed in intra cytoplasma of trophoeyte of placentas of both groups.In the ICP group,the expression of IL-10 was obviously lower than that of control,meanwhile the expression of TNF-α was obviously higher than that control（P 0.05）.Furthermore,TNF-α and serum transaminase were positively correlated（r = 0.270,0.246,P 0.05）,but serum transaminase and IL-10 levels demonstrated negative correlation（r=-0.250,-0.128,P 0.05）.We can conclude that the increase of type 1 cytokine（TNF-α） is associated with a decrease of type 2 cytokine（IL-10） in ICP,and the imbalance of cytokine network may participate in the pathogenesis of ICP through affecting the liver function.