妊娠期肝内胆汁淤积症外周血IL-12及TNF-α检测的临床意义

Clinical value of the detection of serum IL-12 and TNF-α in patients with intrahepatic cholestasis of pregnancy

目的观察妊娠期肝内胆汁淤积症(ICP)患者外周血清肿瘤坏死因子α(TNF-α)和白介素12(IL-12)的水平,探讨其与患者临床发病程度及围产结局的相关性。方法选取本院产科2013年1月至2015年1月收治的113例ICP患者,根据发病程度分为三组:轻度ICP 31例、中度ICP 52例、重度ICP 30例,并以同期入院的101例健康孕产妇为对照组;抽取各组孕产妇清晨空腹外周血,采用ELISA试剂盒测定其血清TNF-α和IL-12的水平。结果对照组、轻度ICP、中度ICP、重度ICP的IL-12水平分别为(8.22±1.05)ng/L、(27.2±3.25)ng/L、(46.5±3.83)ng/L、(66.3±5.24)ng/L,TNF-α水平分别为(31.2±4.52)ng/L、(67.2±6.25)ng/L、(82.3±7.79)ng/L、(126±13.2)ng/L,各组之间的差异均有统计学意义(P<0.01);ICP患者剖宫产率为61.1%(69/113),剖宫产患者IL-12、TNF-α水平分别为(62.3±7.35)ng/L、(93.2±11.4)ng/L,阴道分娩患者的分别为(58.3±6.04)ng/L、(87.5±10.7)ng/L,组间比较差异均有统计学意义(P<0.05);ICP患者不良妊娠结局发生率为35.4%(40/113),不良妊娠结局患者IL-12、TNF-α水平分别为(67.3±7.06)ng/L、(119±13.0)ng/L,正常妊娠者分别为(40.2±5.89)ng/L、(86.5±9.37)ng/L,组间比较差异均有统计学意义(P<0.01)。结论 IL-12及TNF-α水平与ICP的发病程度呈正相关,可作为围产结局的预测指标。

Objective To observe the serum level of IL-12 and TNF-α in patients with intrahepatic cholestasis of pregnancy(ICP), so as to explore their correlation with disease degree and perinatal outcome. Methods A total of 113 patients with ICP accepted in our hospital between January 2013 and January 2015 were selected and divided into three groups according to their disease degree: 31 cases of mild ICP, 52 cases of moderate ICP and 30 cases of severe ICP. At the same time, 101 healthy pregnant women were selected as the control group. The peripheral blood of all these pregnant women was extracted to detect serum levels of IL-12 and TNF-α. Results The serum ILα12 level of the control group, mile ICP, moderate ICP and severe ICP were respectively(8.22±1.05) ng/L,(27.2±3.25) ng/L,(46.5±3.83) ng/L and(66.3±5.24) ng/L; the serum TNF-α level were respectively(31.2±4.52) ng/L,(67.2±6.25) ng/L,(82.3±7.79) ng/L and(126±13.2) ng/L; and there were statistically significant differences between groups(P<0.01). The cesarean rate of ICP patients was 61.1%(69/113). The serum IL-12 and TNF-α levels were respectively(62.3±7.35) ng/L and(93.2±11.4) ng/L,while in patients with vaginal delivery the serum IL-12 and TNF-α levels were respectively(58.3 ± 6.04) ng/L, and(87.5 ± 10.7) ng/L, with statistically significant differences between groups(P<0.05). The incidence of adverse pregnancy outcomes was 35.4%(40/113). The serum IL-12 and TNF-α levels were respectively(67.3 ± 7.06) ng/L and(119±13.0) ng/L, while the serum IL-12 and TNF-α levels in patients without adverse pregnancy outcomes were respectively(40.2±5.89) ng/L and(86.5±9.37) ng/L, with statistically significant differences between groups(P<0.05).Conclusion The serum level of IL-12 and TNF-α were positively correlated with the disease degree of ICP, which therefore might be used as predictor factors of perinatal outcome.