肝功能异常乙型肝炎孕妇孕早期血清IL-1、IL-12及IFN-α水平变化及预测价值分析

Changes and predictive value of serum IL-1,IL-12 and IFN-αlevels in earlypregnancy in hepatitis B pregnant women with abnormal liver function

目的探究肝功能异常乙型肝炎孕妇孕早期血清白细胞介素-1(IL-1)、白细胞介素-12(IL-12)及干扰素-α(IFN-α)水平变化及预测价值分析。方法选取2022年1月至2022年5月石家庄市妇幼保健院100例孕早期肝功能正常乙型肝炎孕妇,根据孕中晚期是否发生肝功能异常分为肝功能正常组(52例)和肝功能异常组(48例),另选同期石家庄市妇幼保健院同孕周50例健康孕妇作为对照组。比较3组一般资料、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)]、血清IL-1、IL-12、IFN-α水平。并比较肝功能异常组不同肝功能异常程度孕妇血清IL-1、IL-12、IFN-α水平,分析血清IL-1、IL-12、IFN-α水平与肝功能异常程度的关系,及其预测乙型肝炎孕妇孕中晚期发生肝功能异常的价值。结果孕早期血清ALT、AST、GGT、IL-1、IL-12水平在3组中由高到低为肝功能异常组、肝功能正常组、对照组(P<0.05),IFN-α水平在3组中由低到高为肝功能异常组、肝功能正常组、对照组(P<0.05);肝功能异常组3种酶浓度值均异常12例,2种酶浓度值异常16例,1种酶浓度值异常20例。IL-1、IL-12水平由高到低为3种酶浓度值均异常孕妇、2种酶浓度值异常孕妇、1种酶浓度值异常孕妇(P<0.05),IFN-α水平由低到高为3种酶浓度值均异常孕妇、2种酶浓度值异常孕妇、1种酶浓度值异常孕妇(P<0.05);肝功能异常组血清IL-1、IL-12水平与肝功能异常程度呈正相关(r=0.771、0.793,P<0.05),IFN-α水平与肝功能异常程度呈负相关(r=-0.755,P<0.05);孕早期血清IL-1、IL-12、IFN-α联合预测乙型肝炎孕妇孕中晚期发生肝功能异常的曲线下面积为0.936(95%CI:0.869~0.976,P<0.05)。结论乙型肝炎孕妇孕早期血清IL-1、IL-12及IFN-α水平与孕中晚期肝功能异常程度密切相关,3项血清指标联合检测对预测乙型肝炎孕妇孕中晚期肝功能异常有较高预测价值。

Objective To explore the changes and predictive value of serum interleukin-1(IL-1),interleukin-12(IL-12)and interferonα(IFN-α)levels in early pregnancy in hepatitis B pregnant women with abnormal liver function.Methods A total of 100 hepatitis B pregnant women with normal liver function in early pregnancy in Shijiazhuang Maternal and Child Health Hospital from January 2022 to May 2022 were selected,and were divided into normal liver function group(52 cases)and abnormal liver function group(48 cases)according to whether there was abnormal liver function in middle and late pregnancy,and another 50 healthy pregnant women of the same gestational week in the same period in Shijiazhuang Maternal and Child Health Hospital were selected as the control group.The general information,liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamine transferase(GGT)],serum interleukin(IL)-1,IL-12,and interferonα(IFN-α)levels among the three groups were compared.The serum levels of IL-1,IL-12,IFN-αin pregnant women with different degrees of liver dysfunction in the liver dysfunction group were compared,and the relationship between the serum levels of IL-1,IL-12,IFN-αand the degree of liver dysfunction was analyzed,as well as the value of predicting liver dysfunction in pregnant women with hepatitis B in the middle and late pregnancy.Results The serum levels of ALT,AST,GGT,IL-1 and IL-12 in early pregnancy from high to low in three groups were liver dysfunction group,normal liver function group,and control group(P<0.05),while the level of IFN-αin early pregnancy from low to high in three groups were liver dysfunction group,normal liver function group,and control group(P<0.05).In the abnormal liver function group,there were 12 cases with abnormal concentration values of 3 enzymes,16 cases with abnormal concentration values of 2 enzymes,and 20 cases with abnormal concentration values of 1 enzyme.The levels of IL-1 and IL-12 from high to low were pregnant women with 3 abnormal values of enzyme,2 abnormal values of enzyme,and 1 abnormal value of enzyme(P<0.05).The level of IFN-αfrom low to high were pregnant women with 3 abnormal values of enzyme,2 abnormal values of enzyme,and 1 abnormal value of enzyme(P<0.05).The levels of serum IL-1 and IL-12 in the abnormal liver function group were positively correlated with the degree of liver function abnormality(r=0.771,0.793,P<0.05),while the levels of IFN-αwere negatively correlated with the degree of liver function abnormality(r=-0.755,P<0.05).The area under the curve of serum IL-1,IL-12 and IFN-αin the early pregnancy for predicting abnormal liver function of hepatitis B pregnant women in the middle and late pregnancy was 0.936(95%CI:0.869-0.976,P<0.05).Conclusion The levels of serum IL-1,IL-12 and IFN-αin early pregnancy of hepatitis B pregnant women are closely related to the degree of liver dysfunction in the middle and late pregnancy,and the combined detection of the three serum indicators has a high predictive value for predicting the liver dysfunction in the middle and late pregnancy of hepatitis B pregnant women.