妊娠期肝内胆汁淤积症患者血清IL-17、ICAM-1与肝功能的相关性分析

Correlation analysis of serum IL-17,ICAM-1 and liver function in patients with intrahepatic cholestasis of pregnancy

目的:分析妊娠期肝内胆汁淤积症(ICP)患者血清白细胞介素IL-17、细胞间黏附分子-1(ICAM-1)与肝功能的相关性。方法:选择2019年1月至2020年8月在我院就诊的ICP患者125例,根据《妊娠期肝内胆汁淤积症诊疗指南》的ICP临床分度标准,将其分为轻度组(n=71)、重度组(n=54),同时选取100例正常妊娠妇女为对照组。入院24 h内检测所有受试者血清IL-17、ICAM-1水平以及肝功能指标,并进一步分析血清IL-17、ICAM-1平与肝功能指标的关系。结果:重度组患者TBA、AST、ALT、TBil、γ-GT、IL-17、ICAM-1均明显高于轻度组、对照组,且轻度组亦高于对照组,差异均具统计学意义(P<0.05);重度组患者出现产后出血、早产儿、羊水污染、胎儿窘迫、胎儿宫内窒息、死胎的概率均明显高于对照组,差异均具统计学意义(P<0.05),而重度组与轻度组患者不良妊娠结局比较,差异则无统计学意义(P>0.05);不良妊娠结局患者TBA、AST、ALT、TBil、γ-GT、IL-17、ICAM-1水平均明显高于正常妊娠结局患者,差异均具统计学意义(P<0.05)。此外Pearson检验发现,ICP患者血清IL-17、ICAM-1水平与TBA、AST、ALT、TBil、γ-GT均呈正相关(P<0.01)。结论:ICP患者血清IL-17、ICAM-1水平影响患者的肝功能,且对围产期母婴的危害性较大,及时监测其表达水平对预测不良妊娠结局具有积极的作用。

Objective:To analyze the correlation between serum interleukin (IL-17),intercellular adhesion molecule-1 (ICAM-1),and liver function in patients with intrahepatic cholestasis of pregnancy (ICP).Methods:A total of 125 ICP patients who were treated in our hos-pital from January 2019 to August 2020 was selected and divided into the mild group according to the ICP clinical grading standard in the guidelines for the diagnosis and treatment of intrahepatic cholestasis of pregnancy (n=71),severe group (n=54),and 100 normal pregnant women were selected as the control group.The serum levels of IL-17,ICAM-1,and liver function indexes were detected within 24 hours after admission,and the relationship between serum IL-17,ICAM-1 levels,and liver function indexes were further analyzed.Results:The TBA,AST,ALT,TBil,γ-GT,IL-17,and ICAM-1 in the severe group were significantly higher than those in the mild group and the control group,and the mild group was also higher than the control group,the differences were statistically significant (P<0.05).The incidence of postpartum hemorrhage,premature infants,amniotic fluid contamination,fetal distress,fetal asphyxia,and stillbirth in the severe group was significantly higher than those in the control group,and the differences were statistically significant (P<0.05),while the severe was no sta-tistically significant difference in adverse pregnancy outcomes between the group and the mild group (P>0.05).The levels of TBA,AST,ALT,TBil,γ-GT,IL-17,and ICAM-1 in patients with adverse pregnancy outcomes were significantly higher than In patients with normal pregnancy outcomes,the differences were statistically significant (P<0.05).In addition,Pearson test found that serum IL-17 and ICAM-1levels of ICP patients were positively correlated with TBA,AST,ALT,TBil,and γ-GT (P<0.01).Conclusion:The serum IL-17 and ICAM-1 levels in ICP patients affect the liver function of patients,increase pregnancy and obstetric abnormalities,Timely monitoring of their expression levels is positive for predicting adverse pregnancy outcomes.