多烯磷脂酰胆碱辅助治疗对妊娠期肝内胆汁淤积症患者免疫功能及SOCS-3、TNF-α、IL-12表达的影响

Effect of polyene phosphatidyl choline on immune function and expression of SOCS-3, TNF-α and IL-12 in patients with intrahepatic cholestasis of pregnancy

目的探究多烯磷脂酰胆碱辅助治疗对ICP患者免疫功能及细胞因子信号传导负调控因子3(SOCS-3)、肿瘤坏死因子α(TNF-α)、白细胞介素12(IL-12)表达的影响。方法将100例患者随机分为两组,对照组患者使用腺苷蛋氨酸联合熊去氧胆酸治疗,观察组患者在治疗组基础上使用多烯磷脂酰胆碱辅助治疗。对比两组患者治疗前后瘙痒评分、谷草转氨酶(AST)、谷丙转氨酶(ALT)、血清总胆汁酸(TBA)、IL-12、TNF-α以及SOCS-3水平。结果治疗前两组患者各项指标差异无统计学意义(P>0.05),治疗后均好转。治疗后,观察组Ribaha评分、TBA、AST及ALT水平低于对照组(P<0.05),观察IL-12、TNF-α水平组低于对照组(P<0.05),观察组SOCS–3蛋白水平高于对照组(P<0.05)。观察组不良妊娠结局的发生率低于对照组(P<0.05)。结论多烯磷脂酰胆碱辅助治疗ICP可有效改善患者皮肤瘙痒和肝功能,提高SOCS-3水平,降低TNF-α、IL-12水平,降低不良妊娠结局的发生率。

Objective To investigate the effect of polyene phosphatidylcholine as supplementary therapy on immune function in patients with intrahepatic cholestasis of pregnancy （ICP）. Methods A total of 100 patients were included and randomly divided into control group from which patients received standard treatment, and observation group from which patients received treatment of polyene phosphatidylcholine in addition to standard treatment. Levels of ALT, AST, TBA, IL-12, TNF-α and SOCS-3 were measured in all patients. Results No significant difference in all markers between the two groups was observed before any treatments （P 〉 0.05）. After treatment, clinical markers of the disease post-treatment indicated patients being recovered. Levels of Ribaha, TBA, AST and ALT in the observation group were signifcantly decreased when compared with control group （P 〈 0.05）. Levels of IL-12 and TNF-α were dramatically increased when compared with control group （P 〈 0.05）. Observation group with treatment of polyene phosphatidylcholine experienced signifcantly higher expression of SOCS-3 while less adverse outcomes when compared with control group （P 〈 0.05）. Conclusion Polyenoic phosphatidylcholine combined with standard treatment effectively improves the outcome of patients with ICP potentially through SOCS-3-mediated inhibition of immune function.