IFN-γ、IL-10、E_(2)、β-hCG在妊娠合并梅毒患者血清中的表达水平及其临床意义

Detection Levels and Significance of Serum IFN-γ,IL-10,E_(2) and β-hCG in Pregnant Syphilis Patients

【目的】探讨γ干扰素(IFN-γ)、白细胞介素-10(IL-10)、雌二醇(E_(2))、β人绒毛促性腺激素(β-hCG)在妊娠合并梅毒(PS)患者血清中的表达水平及其临床意义。【方法】选择2018年7月至2020年7月在西安市第九医院诊治的妊娠合并PS患者92例为PS组,按照妊娠结局分为良好妊娠结局组和不良妊娠结局组;另外选取同期在西安市第九医院产检的正常妊娠孕妇85例为对照组。比较不同组别患者血清中IFN-γ、IL-10、E_(2)、β-hCG的表达水平,受试者工作特征曲线(ROC)分析血清中IFN-γ、IL-10、E_(2)、β-hCG的表达水平对PS患者不良妊娠结局的诊断价值,Logistic回归分析PS患者不良妊娠结局的危险因素。【结果】PS患者血清中IL-10、E_(2)、β-hCG的水平显著低于对照组(P<0.05),且随着梅毒严重程度的增加而降低,IFN-γ的表达水平显著高于对照组(P<0.05),且随着梅毒严重程度的增加而升高;与良好妊娠结局组相比,不良妊娠结局组PS患者血清中IL-10、E_(2)、β-hCG的表达水平显著降低(P<0.05),IFN-γ的表达水平显著升高(P<0.05);ROC曲线结果表明,血清IFN-γ、IL-10、E_(2)、β-hCG表达水平诊断PS患者不良妊娠结局曲线下面积(AUC)分别为0.865、0.821、0.717、0.816,四者联合诊断PS患者不良妊娠结局的AUC为0.936,明显高于血清中IFN-γ、IL-10、E_(2)、β-hCG的表达水平单独诊断(P<0.05);IFN-γ水平升高及IL-10、E_(2)、β-hCG水平降低均是PS患者发生不良妊娠结局的危险因素(P<0.05)。【结论】PS患者血清中IFN-γ、IL-10、E_(2)、β-hCG的表达水平与PS病情及PS患者不良妊娠结局密切相关,对不良妊娠结局的发生具有一定的诊断价值。

【Objective】To detect the expression levels of interferon-γ(IFN-γ),interleukin-10(IL-10),estradiol(E_(2))andβ-human chorionic gonadotropin(β-hCG)in serum of pregnant syphilis(PS)patients,and to analyze their clinical significance.【Methods】A total of 92 patients with pregnancy complicated with PS treated in Xi'an Ninth Hospital from July 2018 to July 2020 were selected as PS group.They were divided into good pregnancy outcome group and bad pregnancy outcome group according to pregnancy outcome;In addition,85 normal pregnant women who underwent prenatal examination in Xi'an Ninth Hospital in the same period were selected as the control group.The expression level o serum IFN-γ,IL-10,E_(2) andβ-hCG of patients in different groups were compared;The expression level serum IFN-γ,IL-10,E_(2) andβ-hCG was analyzed by receiver operating characteristic curve(ROC)in the value of the diagnosis of adverse pregnancy outcomes in patients with PS;Logistic regression was used to analyze the risk factors of adverse pregnancy outcomes in patients with PS.【Results】The level of IL-10,E_(2) andβ-hCG of the PS patients was significantly lower than that of the control group(P<0.05),and decreased with the increase of syphilis severity,and the expression level of IFN-γwas significantly higher than that in the control group(P<0.05),and increased with the increase of the severity of syphilis;Compared with the good pregnancy outcome group,the expression level of the serum levels of IL-10,E_(2) andβ-hCG in PS patients of the adverse pregnancy outcome group decreased significantly(P<0.05),and the expression level of IFN-γwas significantly increased(P<0.05);ROC curve showed that the area under the curve(AUC)of serum IFN-γ,IL-10,E_(2) andβ-hCG expression level in the diagnosis of adverse pregnancy outcome in patients with PS were 0.865,0.821,0.717 and 0.816 respectively.The AUC of adverse pregnancy outcome in PS patients diagnosed by the combination of the four was 0.936,which was significantly higher than that diagnosed by serum IFN-γ,IL-10,E_(2) andβ-hCG expression alone(P<0.05).【Conclusion】The expression level in serum IFN-γ,IL-10,E_(2) andβ-hCG in PS patients is closely related to the condition of PS and the adverse pregnancy outcome of PS patients,which has a certain diagnostic value for the occurrence of adverse pregnancy outcome.