血清MMP-2、MMP-9、IL-17表达与妊娠期肝内胆汁淤积症发生的相关性分析

Correlation Analysis of Risk of Intrahepatic Cholestasis of Pregnancy with Expression of Serum MMP-2,MMP-9 and IL-17

【目的】探讨血清基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、白介素-17(IL-17)与妊娠期肝内胆汁淤积症(ICP)发生的关系。【方法】选取2020年1月至2022年1月在乾县中医医院住院并分娩的75例ICP患者(ICP组),并选取同期在本院住院并分娩且无妊娠并发症的75例正常孕产妇(对照组)。比较两组血清MMP-2、MMP-9、IL-17、总胆红素(TBIL)、直接胆红素(DBIL)水平,采用受试者工作特征(ROC)曲线分析血清MMP-2、MMP-9、IL-17、TBIL、DBIL评估妊娠期发生ICP的价值。根据病情严重程度将75例ICP患者为轻症组(n=45)与重症组(n=30),比较不同病情严重程度患者血清MMP-2、MMP-9、IL-17、TBIL、DBIL水平,通过Spearman相关系数分析血清MMP-2、MMP-9、IL-17、TBIL、DBIL水平与ICP患者严重程度的关系。【结果】ICP组血清MMP-2、MMP-9、IL-17、TBIL、DBIL水平均显著高于对照组,差异有统计学意义(P<0.05);ROC曲线分析显示:MMP-2≥176.277 ng/mL、MMP-9≥679.489 ng/mL、IL-17≥12.597 pg/mL、TBIL≥13.208μmol/L、DBIL≥3.998μmol/L是评估妊娠期发生ICP的最佳截断值;轻症组血清MMP-2、MMP-9、IL-17、TBIL、DBIL水平均显著低于重症组,其差异有统计学意义(P<0.05);相关性分析显示:ICP患者病情严重程度与血清MMP-2、MMP-9、IL-17、TBIL、DBIL水平呈正相关(均P<0.05)。【结论】血清MMP-2、MMP-9、IL-17水平与ICP发生密切相关,且与ICP严重程度呈正相关。

【Objective】To study the relationship of intrahepatic cholestasis of pregnancy(ICP)with matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),interleukin-17(IL-17).【Methods】A total of 75 ICP patients who were hospitalized and delivered in Qian County Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected as the ICP group,and 75 normal pregnant women who were hospitalized and delivered without pregnancy complications in our hospital during the same period were selected as the control group.The levels of serum MMP-2,MMP-9,IL-17,total bilirubin(TBIL)and direct bilirubin(DBIL)were compared between the two groups.The value of ICP in pregnancy was evaluated by ROC analysis of serum MMP-2,MMP-9,IL-17,TBIL and DBIL.All 75 ICP patients were divided into the mild group(n=45)and the severe group(n=30)according to the severity of the disease.The levels of serum MMP-2,MMP-9,IL-17,TBIL,DBIL in patients with different severity of the disease were compared.The relationship of the severity of ICP patients with serum MMP-2,MMP-9,IL-17,TBIL and DBIL was analyzed by Spearman correlation coefficient.【Results】Serum levels of MMP-2,MMP-9,IL-17,TBIL and DBIL in the ICP group were significantly higher than those in control group(P<0.05).ROC curve analysis showed that MMP-2≥176.277 ng/mL,MMP-9≥679.489 ng/mL,IL-17≥12.597 pg/mL,TBIL≥13.208μmol/L and DBIL≥3.998μmol/L were the best cut-off value to evaluate ICP during pregnancy(all P<0.05).Serum levels of MMP-2,MMP-9,IL-17,TBIL and DBIL in the mild group were significantly lower than those in the severe group(P<0.05).Through correlation analysis,the severity of ICP patients was positively correlated with serum MMP-2,MMP-9,IL-17,TBIL and DBIL levels(P<0.05).【Conclusion】Serum levels of MMP-2,MMP-9 and IL-17 are closely related to the occurrence of ICP,and they are positively related to the severity of ICP as well.