外周血中γ干扰素和白细胞介素-23表达与复发性流产的相关性研究

Study on the correlation between the expression of interferon gamma and interleukin-23 in peripheral blood and recurrent miscarriage

目的探讨外周血中γ干扰素(IFN-γ)和白细胞介素-23(IL-23)表达与复发性流产(RPL)的相关性研究。方法选取2022年1—12月佛山市妇幼保健院接收的50例RPL病人为研究对象,同期健康体检者50例为对照组。采用酶联免疫吸附测定(ELISA)检测血清IFN-γ、IL-23水平;采用多因素logistic回归分析探索RPL发生的影响因素;采用Pearson法分析血清IFN-γ、IL-23水平与临床资料的相关性;采用受试者操作特征曲线(ROC曲线)评价血清IFN-γ、IL-23及其联合对RPL发生的预测效能。结果相较于对照组,RPL组年龄、血红蛋白、CD4^(+)/CD8^(+)、蛋白C、抗心磷脂抗体(ACA)IgA、IFN-γ[(25.95±7.44)ng/L比(17.72±4.57)ng/L]、IL-23[(4.32±1.37)μg/L比(2.99±0.81)μg/L]水平显著升高(P<0.05),CD8^(+)、ACA IgG水平显著降低(P<0.05)。logistic分析发现,年龄、CD4^(+)/CD8^(+)、IFN-γ、IL-23均是RPL发生的独立危险因素(P<0.05);CD8^(+)是RPL发生的独立保护因素(P<0.05)。RPL病人血清IFN-γ与IL-23、年龄、CD4^(+)/CD8^(+)呈正相关(r=0.61、0.59、0.52,P<0.05),与CD8^(+)呈负相关(r=−0.57,P<0.05)。血清IL-23与年龄、CD4^(+)/CD8^(+)正相关(r=0.55、0.56,P<0.05),与CD8^(+)负相关(r=−0.52,P<0.05)。ROC结果显示血清中IFN-γ、IL-23水平及二者联合预测RPL发生的AUC分别为0.79、0.77、0.88,其中联合预测AUC显著高于二者单独预测AUC(P<0.05)。结论RPL病人血清中IFN-γ、IL-23水平升高,与机体的免疫功能关系密切,均有望成为RPL发生的预测因子。

Objective To study the correlation between the expression of interferon gamma(IFN-γ)and interleukin-23(IL-23)in peripheral blood and recurrent miscarriage(RPL).Methods From January 2022 to December 2022,50 patients with RPL admitted to Foshan Maternal and Child Health Hospital were selected as research subjects,and 50 healthy subjects during the same period were selected as the control group.The levels of serum IFN-γand IL-23 were detected by enzyme-linked immunosorbent assay(ELISA);Logistic multiple factor regression was applied to analyze the influencing factors of RPL;Pearson method was applied to analyze the level of serum IFN-γand IL-23 and their correlation with clinical data;the predictive effect of serum IFN-γ,IL-23 and their combination on the occurrence of RPL was evaluated by the ROC curve.Results Compared with the control group,the levels of age,hemoglobin,CD4^(+)/CD8^(+),protein C,ACA IgA,IFN-γand IL-23 in RPL group were obviously higher(P<0.05),the levels of CD8^(+)and ACA IgG were obviously lower(P<0.05).Logistic analysis showed that age,CD4^(+)/CD8^(+),IFN-γand IL-23 were independent risk factors for RPL(P<0.05);CD8^(+)was an independent protective factor for RPL(P<0.05).Serum IFN-γin RPL patients was positively correlated with IL-23,age,CD4^(+)/CD8^(+)(r=0.61,0.59,0.52,P<0.05),and negatively correlated with CD8^(+)(r=−0.57,P<0.05).Serum IL-23 was positively correlated with age,CD4^(+)/CD8^(+)(r=0.55,0.56,P<0.05),and negatively correlated with CD8^(+)(r=−0.52,P<0.05).The ROC results showed that the AUC of the levels of IFN-γand IL-23 in serum and the combination for predicting the occurrence of RPL was 0.79,0.77 and 0.88,respectively,the AUC of combined prediction was obviously higher than the AUC of two independent prediction(P<0.05).Conclu⁃sion The levels of IFN-γand IL-23 in the serum of patients with RPL are increased,and are closely related to the immune function of the body,which are expected to be the predictors of RPL.