妊娠期肝内胆汁淤积症患者细胞炎症因子与肝功能的关系及其对妊娠结局的影响

Imbalance of inflammatory cytokine levels in patients with intrahepatic cholestasis of pregnancy: Correlation with liver dysfunction and impact on pregnancy outcome

目的探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)患者细胞炎症相关因子与肝功能的关系及其对妊娠结局的影响方法采用回顾性临床研究,选取2014-01/2016-10确诊为孕晚期ICP患者72例为研究对象,其中,符合轻度ICP者40例(轻度组),符合重度ICP者32例(重度组),另选取同期90例正常妊娠无并发症孕晚期孕妇为对照组,留取禁食后血清总胆汁酸(total bile acids,TBA)、谷草转氨酶(aspartate transaminase,AST)、谷丙转氨酶(alanine transaminase,ALT)、白介素(interleukin,IL)-6、IL-10、IL-12和肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)标本后送检.采用ELISA法测定两组血清IL-6、IL-10、IL-12和TNF-α水平,应用全自动生化分析仪测定肝功能指标.结果ICP组患者血清IL-6、IL-10、IL-12、TNF-α、TBA、ALT、AST水平显著高于对照组,差异有统计学意义(P<0.05);ICP重度组患者血清IL-6、IL-10、IL-12、TNF-α、TBA、ALT、AST水平高于轻度组,差异有统计学意义(P<0.05),经Pearson相关因素分析显示,IL-6、IL-10、IL-12、TNF-α与TBA、ALT、AST水平均呈正相关(P<0.05).结论妊娠期肝内胆汁淤积症患者炎症细胞因子水平影响患者的肝功能,肝功能指标及细胞炎症因子对预测不良妊娠结局具有积极的作用.

AIM To investigate whether patients with intrahepatic cholestasis of pregnancy（ICP） develop the imbalance of inflammatory cytokines levels, and analyze its relationship with liver dysfunction and pregnancy outcome.METHODS Seventy-two ICP patients treated between January 2014 and October 2016 were selected, including 40 cases of mild ICP and 32 cases of moderate to severe ICP. Ninety healthy pregnant women without complications in third trimester were included as controls. ELISA was used to detect the levels of serum interleukin（IL）-6, IL-10, IL-12, and tumor necrosis factor α（TNF-α）. An automatic biochemical analyzer was used to detect liver function indexes.RESULTS The levels of serum IL-6, IL-10, IL-12, TNF-α, total bile acids（TBA）, alanine transaminase（ALT）, and aspartate transaminase（AST） in the ICP group were statistically significantly higher than those in the control group（P〈0.05）. In the ICP group, the levels of serum IL-6, IL-10, IL-12, TNF-α, TBA, ALT, and AST in moderate to severe cases were statistically significantly higher than those in mild cases（P〈0.05）. Pearson correlation analysis showed that serum IL-6, IL-10, IL-12, and TNF-α levels were positively correlated with TBA, ALT and AST levels（P〈0.05）.CONCLUSION The imbalance of inflammatory cytokines levels closely correlates with liver dysfunction and adverse pregnancy outcome in ICP patients. Detecting liver function and inflammatory cytokines may predict adverse pregnancy outcome in ICP patients.