摘要
目的探讨妊娠期肝内胆汁淤积症（ICP）患者人类白细胞抗原G（HLA-G）与Th1/Th2细胞因子的相关性。方法选取2014年1月~2015年12月在江苏省常熟市中医院确诊的90例ICP剖宫产引产孕妇娩出的胎盘组织作为观察组,另选取同期90例因脐带绕颈或胎儿臀位行剖宫产的正常孕妇娩出的胎盘组织作为对照组,采用免疫组化法对胎盘组织中HLA-G表达情况进行检测,检测孕妇血清总胆汁酸（TBA）、白细胞介素-4（IL-4）和肿瘤坏死因子-α（TNF-α）水平,比较两组TBA、IL-4和TNF-α水平及胎盘组织中HLA-G表达,并分析HLA-G与Th1/Th2细胞因子相关性。结果观察组TBA、TNF-α及TNF-α/IL-4水平均高于对照组,IL-4水平低于对照组（P〈0.01）。观察组胎盘组织中HLA-G阳性表达程度明显低于对照组（P〈0.01）。ICP患者胎盘组织中HLA-G与TNF-α和TNF-α/IL-4呈负相关（r=-0.751,P=0.024;r=-0.235,P=0.000）,与IL-4无明显相关性（P=0.305）。TBA与HLA-G呈负相关（r=-0.766,P=0.013）,与TNF-α和TNF-α/IL-4呈正相关（r=0.821,P=0.033;r=0.731,P=0.024）,与IL-4无明显相关性（P=0.479）。结论 HLA-G下降可能导致ICP患者TNF-α水平升高,使Th1表达处于优势状态,导致Th1/Th2失衡,促使母体对胎儿产生排斥。
Objective To explore the relationship between human leukocyte antigen G（HLA-G） and Th1/Th2 cytokines in patients with intrahepatic cholestasis of pregnancy（ICP）. Methods 90 cases of placental tissues of ICP diagnosed and treated with cesarean delivery of the placenta induction of labor in Hospital of Traditional Chinese Medicine in Changshu City, Jiangshu Province from January 2014 to December 2015 were selected as observation group, and another 90 cases of placental tissues of normal pregnant women undergoing of fetal breech cesarean delivery due to umbilical cord around the neck or breech presentation in the same period were selected as control group. The immunohistochemistry method was used to detect the expressions of HLA-G in placental tissues. The levels of serum total bile acid（TBA）, tumor necrosis factor-α（TNF-α） and interleukin-4（IL-4） were detected in the pregnant women between two groups.The levels of TBA, IL-4 and TNF-α and the expressions of HLA-G were compared between two groups, then the relationship between HLA-G and Th1/Th2 cytokines was analyzed. Results The levels of TBA, TNF-α and TNF-α/IL-4 in observation group were higher than those in control group, and the IL-4 of observation group was lower than that of control group（P〈0.01）. In the placental tissues of observation group, the degree of positive expression in HLA-G was obviously lower than that in control group（P〈0.01）. The expression of HLA-G was negatively correlated with TNF-αand TNF-α/IL-4 in the placental tissues of patients with ICP（r=-0.751, P=0.024; r=-0.235,P=0.000） and there was no significant correlation between HLA-G and IL-4（P=0.305）. TBA was negatively correlated with HLA-G（r=-0.766, P=0.013）, positively correlated with TNF-α and TNF-α/IL-4（r=0.821, P=0.033; r=0.731, P=0.024）, without significant correlation with IL-4（P=0.479）. Conclusion HLA-G decline may lead to rising of TNF-α level in patients with ICP,and Th1 expression in the dominant state leads to imbalance
出处
《中国医药导报》
CAS
2016年第32期90-93,共4页
China Medical Herald
