摘要
目的分析妊娠期肝内胆汁淤积症(ICP)孕妇胎盘组织NF-κB、IL-17和TLR4表达与妊娠结局的关系,为ICP孕妇预后的改善提供依据与指导。方法选取ICP孕妇54例纳入ICP组,健康孕妇46例纳入对照组,根据ICP程度将54例ICP孕妇分为重度组20例与轻度组34例。采集所有孕妇剖宫产后的胎盘组织并检测其NF-κB、IL-17和TLR4表达,比较重度组、轻度组、对照组的年龄、孕周、肝功能指标、胎盘组织中IL-17 mRNA相对表达量、IL-17蛋白相对灰度值(IL-17/β-actin)、NF-κB蛋白的相对灰度值(NF-κB/β-actin)、TLR4蛋白相对灰度值(TLR4/β-actin),比较3组的早产率、胎儿窘迫发生率、死胎率、不良结局发生率,并分析胎盘组织IL-17、NF-κB、TLR4表达与ICP分度及妊娠结局的相关性及其对ICP孕妇妊娠结局的预测价值。结果 3组年龄、孕周差异无统计学意义(P>0. 05);重度组AST、ALT、TBA均高于轻度组与对照组,轻度组高于对照组,差异有统计学意义(P<0. 05)。重度组的IL-17 mRNA相对表达量、IL-17/β-actin、NF-κB/β-actin、TLR4/β-actin均高于轻度组与对照组,轻度组均高于对照组,差异均有统计学意义(P<0. 05)。3组胎儿窘迫、死胎发生率的差异无统计学意义(P>0. 05);重度组与轻度组的早产发生率及不良结局总发生率均显著高于对照组,重度组不良结局总发生率高于轻度组,差异均有统计学意义(P<0. 05)。ICP分度及妊娠结局均与胎盘组织IL-17、NF-κB、TLR4表达呈明显正相关(P<0. 05)。ROC曲线结果显示,胎盘组织IL-17 mRNA相对表达量、IL-17/β-actin、NF-κB/β-actin、TLR4/β-actin预测ICP孕妇妊娠结局的曲线下面积分别为0. 920、0. 943、0. 832、0. 932,灵敏度分别为0. 87、0. 89、0. 80、0. 85,特异度0. 81、0. 83、0. 84、0. 87。结论 ICP孕妇胎盘组织的NF-κB、IL-17和TLR4均存在高表达,且与ICP分度及妊娠结局有明显相关性。随着NF-κB、IL-17和TLR4表达的增加ICP加重,早�
Objective To investigate the relationship between expression of NF-κB, IL- 17 and TLR4 in placenta of pregnant women with intrahepatic eholestasis of pregnancy （ICP） and pregnancy outcome, in order to provide basis and guidance for improving prog- nosis of pregnant women with ICP. Methods A total of 54 pregnant women were included in the ICP group and 46 healthy pregnant women were included in the control group. 54 pregnant women were divided into severe group （n = 20） and mild group （n = 34） according to the ICP level. The expression of NF-κB, IL-17 and TLR4 in placental tissue after cesarean section was detected in all placenta of cesarean sec- tion. The age, gestational age, liver function index, the relative expression of 1L-17 mRNA, the relative gray value of 1L-17 protein （IL- 17/β-actin） , the relative gray value of NF-κB protein （NF-KB/β-actin） , the relative gray value of TLR4 protein （TLR4/β-actin） of placental tissue were compared among the three groups. The preterm birth rate, fetal distress incidence, stillbirth rate, adverse outcome of the total incidence were compared among the three groups. The correlation between expression of IL-17, NF-βB and TLR4 in placental tis- sue and ICP index and pregnancy outcome, and its predictive value for pregnancy outcome of ICP pregnant women were analyzed. Results There were no statistically significant difference in age and gestational age among the three groups （P〉0. 05） . The levels of AST, ALT and TBA in the severe group were higher than those in the mild group and the control group, while the mild group were higher than those in the control gruup, there were statistically significant differences （P〈O. 05） . The relative expression of 1L-17 mRNA, the levels of IL-17/β-actin, NF-KB/β-actin and TLR4/β-actin in the severe group were significantly higher than those in the mild group and the con- trol group, while the mild group were signifieantly higher than those in the control group, there were statistically signific
作者
李晓林
LI Xiao-Lin(Department of Obstetrics and Gynecology,Maternal and Child Health Hospital of Guangyuan City,Sichuan,Guangyuan 628000,China)
出处
《中国妇幼保健》
CAS
2018年第22期5092-5096,共5页
Maternal and Child Health Care of China
