正常妊娠不同孕期血清hCG及IL-1β、IL-6和TNF-α水平的变化趋势

【目的】探讨正常妊娠妇女在妊娠过程中血清IL-1β、IL-6和TNF-α水平随人绒毛膜促性腺激素hCG水平的变化规律。【方法】采用放射免疫测定法检测正常妊娠妇女在妊娠早、中、晚期血清hCG、TNF-α、IL-1β、IL-6水平，并与未孕妇女（对照组）进行对照研究。【结果】1．妊娠早期血清hCG浓度迅速升高，妊娠中晚期明显降低，但与正常对照组比较仍有显著性差异（P〈0．01）2．IL-1β血清水平在妊娠早期达到较高水平，中期有所下降，晚期又有所升高。3．与对照组比较，正常妊娠TNF-α血清水平在妊娠早、中、晚期均有所下降，但差异无显著性（P〉0．05）。4．正常妊娠早期血清IL-6水平随血清hCG浓度增高而增加，至妊娠中期血清IL-6水平持续增高，妊娠晚期达高峰。5.妊娠早期血清IL-1β／IL-6浓度的比值与对照组比较无显著性差异（P〉0．05），而妊娠中期和晚期差异有显著性（P〈0．01）。血清TNF-α／IL-6的浓度比值在妊娠早期、中期与对照组相比无显著差异（P〉0．05），晚期与对照组相比差异有显著性（P〈0．01）。【结论】妊娠期间细胞因子IL-1β和IL-6血清水平增高；妊娠期间正常分泌的hCG可能在细胞因子的产生中发挥作用；妊娠期间宿主的免疫反应可能发生了Th1向Th2型的转变。

Changes of hCG and IL-1β, IL-6, TNF-α serum level in different phase of pregnancy

Objective] To investigate the changes of IL-1β, IL-6 and TNF-α in the serum following the changing level of hCG in normal pregnancy. Methods] The level of hCG, TNF-α, IL-6 and IL-1β in the serum of normal pregnant women of the early, mid and late trimester of pregnancy was determined by RIA, and compared with the normal control group. Results] 1. The level of serum hCG in the early pregnancy increased significantly and in the mid and late trimester of pregnancy decreased significantly, but there was significant difference in the secretion of hCG between control group and pregnancy group （P 〈 0.01）. 2. A high level of IL-1β in the serum was detected in the trimester of pregnancy, it decreased in the mid pregnancy and increased again in the late trimester of pregnancy. 3. The level of TNF-α in serum was decreased in the different periods of normal pregnancy when compared with the control group, but it was not different significantly when compared with the normal group. 4. The level of IL-6 in serum was increased following the increasing level of hCG in serum, they kept increasing during the mid trimester of pregnancy and arrived at the peak in the late trimester of pregnancy. 5. The ratio of IL-1βIL-6 was not significantly different in the early trimester of pregnancy （ P 〉 0.05）, but it was a significantly different in the mid and late trimester of pregnancy when compared with the control group （ P 〈 0.01）. The ratio of TNF-α/IL-6 was not significantly different in theearly and mid trimester of pregnancy（ P 〉 0.05）, but it was significantly different in the late trimester of pregnancy （ P 〈 0.01）. Conclusions] The level of IL-1β and IL-6 in serum during the gestational periodincrease, the normocrinic hCG may play a role in the production of cytokine during the gestational period and the host immune response may transform from Thl to Th2 during the gestational period.